PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Adult Contact Profile (S-7) - Unification Specialist
New
65280
48960
0
Form and Instruction
S-7
Adult Contact Profile
Assessment for Risk (S-9) - Case Manager
New
32400
24300
0
Form and Instruction
S-9
Assessment for Risk
Assessment for Risk (S-9) - Child
New
65000
48750
0
Form and Instruction
S-9
Assessment for Risk
Assessment for Risk (S-9) - Clinician
New
32400
24300
0
Form and Instruction
S-9
Assessment for Risk
Assessment for Risk (S-9) - Interpreter
New
65100
48825
0
Form and Instruction
S-9
Assessment for Risk
Category 4 Reunification Case Review and Staffing (TBD) - Case Manager
New
29400
55272
0
Form and Instruction
TBD
Category 4 Reunification Case Review and Staffing
Category 4 Reunification Case Review and Staffing (TBD) - Clinician
New
14700
36750
0
Form and Instruction
TBD
Category 4 Reunification Case Review and Staffing
Family Finding and Mobility Mapping (TBD) - Case Manager
New
35100
52650
0
Form and Instruction
TBD
Family Finding and Mobility Mapping
Family Finding and Mobility Mapping (TBD) - Child
New
46800
70200
0
Form and Instruction
TBD
Family Finding and Mobility Mapping
Family Finding and Mobility Mapping (TBD) - Clinician
New
17700
26550
0
Form and Instruction
TBD
Family Finding and Mobility Mapping
Individual Service Plan (S-13) - Case Manager
New
32400
10692
0
Form and Instruction
S-13
Individual Service Plan
Individual Service Plan (S-13) - Clinician
New
32400
10692
0
Form and Instruction
S-13
Individual Service Plan
Individual Service Plan (S-13) - Interpreter
New
65100
21483
0
Form and Instruction
S-13
Individual Service Plan
Initial Assessment (S-8) - Case Manager
New
32400
10692
0
Form and Instruction
S-8
Initial Assessment
Initial Assessment (S-8) - Child
New
65000
21450
0
Form and Instruction
S-8
Initial Assessment
Initial Assessment (S-8) - Clinician
New
32400
10692
0
Form and Instruction
S-8
Initial Assessment
Initial Assessment (S-8) - Interpreter
New
65100
21483
0
Form and Instruction
S-8
Initial Assessment
Sponsor Assessment (S-5) - Case Manager
New
69000
69000
0
Form and Instruction
S-5
Sponsor Assessment
Sponsor Assessment (S-5) - Interpreter
New
69000
69000
0
Form and Instruction
S-5
Sponsor Assessment
Sponsor Assessment (S-5) - Sponsor
New
68900
68900
0
Form and Instruction
S-5
Sponsor Assessment
Sponsor Assessment (S-5) - Unification Specialist
New
68680
68680
0
Form and Instruction
S-5
Sponsor Assessment
UAC Assessment (S-11) - Case Manager
New
32400
72900
0
Form and Instruction
S-11
UAC Assessment
UAC Assessment (S-11) - Child
New
65000
146250
0
Form and Instruction
S-11
UAC Assessment
UAC Assessment (S-11) - Clinician
New
32400
72900
0
Form and Instruction
S-11
UAC Assessment
UAC Assessment (S-11) - Interpreter
New
65100
146475
0
Form and Instruction
S-11
UAC Assessment
UAC Case Review (S-12) - Case Manager
New
65100
32550
0
Form and Instruction
S-12
UAC Case Review
UAC Case Review (S-12) - Clinician
New
65100
32550
0
Form and Instruction
S-12
UAC Case Review
UAC Case Review (S-12) - Unification Specialist
New
65280
32640
0
Form and Instruction
S-12
UAC Case Review
Total burden requested under this ICR:
1394640
1355586
0
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