Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Admission (Form S-18) Modified 65100 21483 0 Form and Instruction S-18
Adult Contact Profile (Portal Form S-5; Path Form S-7) Removed 0 0 0 Form and Instruction S-7
Form and Instruction S-5
Assessment for Risk (Form S-9) Removed 0 0 0 Form and Instruction S-9
Form and Instruction S-9
Case Manager Call Log and Case Notes (Form S-23) Modified 65100 5208 0 Form and Instruction S-23
Child Advocate Recommendation and Appointment (Form S-15) Removed 0 0 0 Form and Instruction S-15
Foster Care Travel Request (Form S-14) Modified 14904 3726 0 Form and Instruction S-14
Home Study Assessment (Form S-6) Removed 0 0 0 Form and Instruction S-6
Form and Instruction S-6
Home Study Referral (Form S-26) Removed 0 0 0 Form and Instruction S-26
Home Study/Post-Release Service (HS/PRS) Primary Provider Entity (Form S-21A) Removed 0 0 0 Form and Instruction S-21A
Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C) Removed 0 0 0 Form and Instruction S-21C
Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B) Removed 0 0 0 Form and Instruction S-21B
Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D) Removed 0 0 0 Form and Instruction S-21D
Individual Service Plan (Form S-13) Removed 0 0 0 Form and Instruction S-13
Form and Instruction S-13
Initial Intakes Assessment (Form S-8) Removed 0 0 0 Form and Instruction S-8
Form and Instruction S-8
Post-Release Service (PRS) Event (Form S-22) Removed 0 0 0 Form and Instruction S-22
Post-Release Service (PRS) Referral (Form S-19) Removed 0 0 0 Form and Instruction S-19
Form and Instruction Form S-19
Sponsor Application (Form S-24) Removed 0 0 0 Form and Instruction S-24
Sponsor Assessment (Form S-5) Removed 0 0 0 Form and Instruction S-5
Form and Instruction S-5
UAC Authorized/ Restricted Call List and Call Log (Form S-20) Modified 65100 5208 0 Form and Instruction S-20
UAC Case Status (Form S-27) Modified 65100 16275 0 Form and Instruction Form S-27
UC Assessment (Form S-11) Removed 0 0 0 Form and Instruction S-11
Form and Instruction S-11
UC Case Review (Form S-12) Removed 0 0 0 Form and Instruction S-12
Form and Instruction S-12
Total burden requested under this ICR: 275304 51900 0  
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