Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Authorization for Release of Records (Form A-5) Modified 9620 4810 0 Form A-5 Authorization for Release of Records (English)
Form A-5s Authorization for Release of Records (Spanish)
Authorization for Release of Records (Form A-5) - Record keeping Modified 9620 4810 0 Form A-5 Authorization for Release of Records
Form A-5s Authorization for Release of Records - Spanish
Behavioral Note (Form A-9E) Removed 0 0 0 Form A-9E Behavioral Note
Care Provider Facility Tour Request (Form A-1A) Modified 620 205 0 Form A-1A Care Provider Facility Tour Request
Care Provider Facility Tour Request (Form A-1A) - Record Keeping Modified 510 1020 0 Form Form A-1A Care Provider Facility Tour Request
Child-Level Event (Form A-9A) Removed 0 0 0 Form A-9A Child-Level Event
Emergency Significant Incident Report (Form A-9B) Removed 0 0 0 Form A-9B Emergency Significant Incident Report - UC Path Version
Form A-9B Emergency Significant Incident Report
Historical Disclosure (Form A-9D) Removed 0 0 0 Form A-9D Historical Disclosure
Key Personnel Minimum Qualifications Checklist and Attestation (Form A-14) Modified 1800 756 0 Form A-14 Key Personnel Minimum Qualifications Checklist and Attestation
Non-Emergency Significant Incident Report and Addendum (Form A-9C) Removed 0 0 0 Form A-9C Emergency Significant Incident Report Addendum - UC Path Version
Form A-9C Emergency Significant Incident Report Addendum - UC Portal Version
Notice to Unaccompanied Alien Children for Class Counsel Visits (Form A-4) Modified 20 5 0 Form A-4 Notice to Unaccompanied Alien Children for Class Counsel Visits
Form A-4s Notice to Unaccompanied Alien Children for Class Counsel Visits - Spanish
Notification of Concern (Form A-7) Removed 0 0 0 Form Form A-7 Notification of Concern
Form and Instruction Form A-7 Notification of Concern Addendum
ORR Waiver Request (Form A-15) Modified 600 198 0 Form Form A-15 ORR Waiver Request
Program Level Event (Form A-10) Removed 0 0 0 Form A-10 Program-Level Event Report - UC Portal Version
Form A-10 Program-Level Event Report and Addendum - UC Path Version
Total burden requested under this ICR: 22790 11804 0  
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