Information Collection

Office of Refugee Resettlement (ORR) Care Provider Healthcare Delivery Report (HDR)

IC 281573 under ICR 202607-0970-010 · OMB 0970-0558.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 ORR HDR Office of Refugee Resettlement (ORR) Care Provider Healthcare Delivery Report (HDR)	Form
1 ORR HDR TAB A_ORR Care Provider Healthcare Delivery Report_Final_6.16.25.xlsx	Form
Submission for Monitoring Generic _0970-0558_ORR Care Provider HDR_6.16.25.docx Monitoring GenIC - ORR Care Provider HDR	IC Document
NOA_ORR UACB - Care Provider HDR_Monitoring GenIC_0970-0558_6.27.25.pdf NOA - ORR Care Provider HDR	IC Document

IC Title:

Agency IC Tracking Number:

ORR-UACB

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1				Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 225

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	225	225
Annual IC Time Burden (Hours)	338	338
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Monitoring GenIC - ORR Care Provider HDR		07/20/2026
NOA - ORR Care Provider HDR		07/20/2026

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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