Unaccompanied Refugee Minors Program Application, and Withdrawal of Application or Declination of Placement Form

OMB 0970-0550

OMB 0970-0550

The Refugee Act of 1980, Pub. L. No. 96-212, 8 U.S.C. 1522, amended the Immigration and Nationality Act to create a domestic refugee resettlement program that provides assistance and services to refugees resettling in the United States. With the enactment of this legislation, the Office of Refugee Resettlement (ORR) established comprehensive requirements for a State-administered refugee resettlement program including child welfare services to unaccompanied refugee minors. The Unaccompanied Refugee Minors (URM) Program currently operates in 15 States and provides the same range of child welfare benefits and services available to other foster children in those States as well as services required by ORR regulation and policy guidance. Originally, the URM Program provided services for refugee minors arriving from overseas unaccompanied by a parent or adult relative. Over the years Congress passed laws making other special populations already in the United States eligible for the URM Program. A completed URM Program Application must be submitted to ORR for eligibility determination, initiation of placement efforts, and approval to enter the URM Program. The URM Program Application is completed on behalf of unaccompanied minors in the United States who are applying for entry into the URM Program. Applications are completed by case managers, attorneys, or other representatives working with minors who are eligible for the URM Program. The application includes biographical data and comprehensive information on the minor and his/her needs (e.g., placement history, family reunification efforts, medical needs, mental and behavioral health needs, etc.). ORR uses the information collected to determine a minor’s eligibility for the URM Program, and to facilitate placement in the program. The application information is also used to provide a recommendation to the ORR Director to approve the minor to enter the URM Program. The Withdrawal of Application or Declination of Placement Form is completed when a minor who has submitted an application for the URM Program wishes to withdraw this application before approval to enter the program, or if the minor has been offered placement and wishes to decline the placement. This form serves as official record for ORR to cease placement efforts, or to offer the proposed placement to another eligible applicant. The forms included in this information collection request were previously approved under OMB #0970-0498. We are requesting approval for the forms under a new OMB number, specific to this collection of information. Minor changes are proposed in comparison to the previously approved version of the form.

The latest form for Unaccompanied Refugee Minors Program Application, and Withdrawal of Application or Declination of Placement Form expires 2023-08-31 and can be found here.

OMB Details

Unaccompanied Refugee Minors Program Application

Federal Enterprise Architecture: Community and Social Services - Social Services

Form 1URM Program Application FormFillable FileableForm

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