Document
Mental Health Assessment Form
ICR 202609-0970-009 · OMB 0970-0509 · Object 174013200.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Mental Health Assessment Form |
| Author | Buckley, Kirsten (ACF) |
| Last Modified By | Writer |
| File Modified | 2026-08-20 |
| File Created | 2026-10-21 |
| Conversion State | complete |
Extracted Text
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to provide ORR with critical health information for unaccompanied children in the care of ORR. Public reporting burden for this collection of information is estimated to average 0.13 hours per respondent, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a mandatory collection of information (see, 45 CFR §§410.1306(g);410.1307). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0509 and the expiration date is XX/XX/XXXX. If you have any comments on this collection of information, please contact [email protected].