OMB control number

U.S. Repatriation Program Forms

OMB 0970-0474 · HHS/ACF.

OMB 0970-0474

The U.S. Repatriation Program (Program) is authorized by Section 1113 of the Social Security Act (42 U.S.C. § 1313) and the assistance provided to mentally ill repatriates found under 24 U.S.C. §§ 321 - 329. This Program also provides services for emergency repatriations which are authorized under Section 1113 and by the extension of the Executive Order (E.O.) precedent, E.O. 12656 (53 CFR 47491). Program regulations are in 45 CFR 211 & 212. The current collection includes eight forms with translations in six languages. The information collected through these forms allows the Office of Human Services Emergency Preparedness and Response (OHSEPR) to fulfill its statutory responsibilities to provide temporary assistance to repatriates. The Program also provides training and technical assistance to states and territories for routine and emergency repatriation. Additionally, OHSEPR provides funding to states for emergency repatriation planning, training, and exercises. In 2025, ACF submitted updates to forms under this collection in response to new Executive Orders. Through that process, OMB requested minor edits to the SSA to align with the updates to the form. Through that revision process the incorrect SSA was inadvertently updated and sent for upload. ACF would like to replace the currently uploaded SSA with the correct version. The correct version matches the data entered in ROCIS in terms of burden estimates and forms approved.

The latest form for U.S. Repatriation Program Forms expires 2027-01-31 and is listed under ICR 202602-0970-008.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form 1 Repatriation Training and Technical Assistance Request Form (document unavailable)	Form
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support - Traditional Chinese (document unavailable)	Form and Instruction
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support - Spanish (document unavailable)	Form and Instruction
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support - Simplified Chinese	Form and Instruction
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support - Russian (document unavailable)	Form and Instruction
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support - French	Form and Instruction
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support - Arabic (document unavailable)	Form and Instruction
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support (document unavailable)	Form and Instruction
Form RR-07 Temporary Assistance Extension Request - Traditional Chinese (document unavailable)	Form and Instruction
Form RR-07 Temporary Assistance Extension Request - Spanish (document unavailable)	Form and Instruction
Form RR-07 Temporary Assistance Extension Request - Simplified Chinese	Form and Instruction
Form RR-07 Temporary Assistance Extension Request - Russian	Form and Instruction
Form RR-07 Temporary Assistance Extension Request - French	Form and Instruction
Form RR-07 Temporary Assistance Extension Request - Arabic (document unavailable)	Form and Instruction
Form RR-07 Temporary Assistance Extension Request (document unavailable)	Form and Instruction
Form RR-06 Refusal of Temporary Assistance - Traditional Chinese	Form and Instruction
Form RR-06 Refusal of Temporary Assistance - Spanish	Form and Instruction
Form RR-06 Refusal of Temporary Assistance - Simplified Chinese	Form and Instruction
Form RR-06 Refusal of Temporary Assistance - Russian	Form and Instruction
Form RR-06 Refusal of Temporary Assistance - French	Form and Instruction
Form RR-06 Refusal of Temporary Assistance - Arabic	Form and Instruction
Form RR-06 Refusal of Temporary Assistance	Form and Instruction
Form RR-05 Repatriation Repayment and Privacy Agreement	Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request - Traditional Chinese	Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request - Spanish	Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request - Simplified Chinese	Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request - Russian	Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request - French	Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request - Arabic (document unavailable)	Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request	Form and Instruction
Form RR-03 Loan Waiver and Deferral Application - Traditional Chinese	Form and Instruction
Form RR-03 Loan Waiver and Deferral Application - Spanish	Form and Instruction
Form RR-03 Loan Waiver and Deferral Application - Simplified Chinese	Form and Instruction
Form RR-03 Loan Waiver and Deferral Application - Russian	Form and Instruction
Form RR-03 Loan Waiver and Deferral Application - French	Form and Instruction
Form RR-03 Loan Waiver and Deferral Application - Arabic	Form and Instruction
Form RR-03 Loan Waiver and Deferral Application	Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request - Traditional Chinese	Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request - Spanish	Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request - Simplified Chinese	Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request - Russian	Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request - French	Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request - Arabic	Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request	Form and Instruction
Form RR-01 Emergency Repatriation Eligibility Application	Form and Instruction
NonSub Change Request - Correct SSA for 0970-0474.docx (document unavailable)	Justification for No Material/Nonsubstantive Change
NonSub Change Request - Compliance Repat - 10Feb2025.docx (document unavailable)	Justification for No Material/Nonsubstantive Change
Supporting Statement A - OHSEPR Repat Forms PTE TTA_0970-0474_CLEAN_Nov152023_Passback update Jan 2024_EO Up.docx (document unavailable)	Supporting Statement A
Repatriation Post-Training Survey	Other-Survey
Repatriation Training and Technical Assistance Request Form	Form
Repatriation Training and Technical Assistance Request Form	Form
Repatriation State Contact List	Other-Contact List
Planning, Training, and Exercise – Budget and Budget Narrative	Other-Narrative
Planning, Training, and Exercise – Annual Workplan	Other-Workplan
Planning, Training, and Exercise – Project Narrative	Other-Narrative
Emergency Repatriation Request for Cost Approval and Federal Support	Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support	Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support	Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support	Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support	Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support	Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support	Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support	Form and Instruction
Temporary Assistance Extension Request	Form and Instruction
Temporary Assistance Extension Request	Form and Instruction
Temporary Assistance Extension Request	Form and Instruction
Temporary Assistance Extension Request	Form and Instruction
Temporary Assistance Extension Request	Form and Instruction
Temporary Assistance Extension Request	Form and Instruction
Temporary Assistance Extension Request	Form and Instruction
Temporary Assistance Extension Request	Form and Instruction
Refusal of Temporary Assistance	Form and Instruction
Refusal of Temporary Assistance	Form and Instruction
Refusal of Temporary Assistance	Form and Instruction
Refusal of Temporary Assistance	Form and Instruction
Refusal of Temporary Assistance	Form and Instruction
Refusal of Temporary Assistance	Form and Instruction
Refusal of Temporary Assistance	Form and Instruction
Refusal of Temporary Assistance	Form and Instruction
Repatriation Repayment and Privacy Agreement	Form and Instruction
Repatriation Repayment and Privacy Agreement	Form and Instruction
Routine Repatriation Reimbursement Request	Form and Instruction
Routine Repatriation Reimbursement Request	Form and Instruction
Routine Repatriation Reimbursement Request	Form and Instruction
Routine Repatriation Reimbursement Request	Form and Instruction
Routine Repatriation Reimbursement Request	Form and Instruction
Routine Repatriation Reimbursement Request	Form and Instruction
Routine Repatriation Reimbursement Request	Form and Instruction
Routine Repatriation Reimbursement Request	Form and Instruction
Loan Waiver and Deferral Application	Form and Instruction
Loan Waiver and Deferral Application	Form and Instruction
Loan Waiver and Deferral Application	Form and Instruction
Loan Waiver and Deferral Application	Form and Instruction
Loan Waiver and Deferral Application	Form and Instruction
Loan Waiver and Deferral Application	Form and Instruction
Loan Waiver and Deferral Application	Form and Instruction
Loan Waiver and Deferral Application	Form and Instruction
Emergency Repatriation Reimbursement Request	Form and Instruction
Emergency Repatriation Reimbursement Request	Form and Instruction
Emergency Repatriation Reimbursement Request	Form and Instruction
Emergency Repatriation Reimbursement Request	Form and Instruction
Emergency Repatriation Reimbursement Request	Form and Instruction
Emergency Repatriation Reimbursement Request	Form and Instruction
Emergency Repatriation Reimbursement Request	Form and Instruction
Emergency Repatriation Reimbursement Request	Form and Instruction
Emergency Repatriation Eligibility Application	Form and Instruction
Emergency Repatriation Eligibility Application	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202602-0970-008	No material or nonsubstantive change to a currently approved collection	2026-02-17	Approved without change
202502-0970-024	No material or nonsubstantive change to a currently approved collection	2025-02-13
202311-0970-008	Revision of a currently approved collection	2023-11-27	Approved with change
202304-0970-011	No material or nonsubstantive change to a currently approved collection	2023-05-01	Approved without change
202204-0970-004	Revision of a currently approved collection	2022-04-12	Approved without change
201903-0970-002	Extension without change of a currently approved collection	2019-03-29	Approved without change
201510-0970-006	New collection (Request for a new OMB Control Number)	2015-11-18	Approved with change

OMB Details

Emergency Repatriation Eligibility Application

Federal Enterprise Architecture: Community and Social Services - Social Services

Information collection instruments
Form	Name	Electronic access	Type
Form RR-01	Emergency Repatriation Eligibility Application	Fillable Printable	Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.