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
Category 4 Discharge Plan (Form R-9)
Modified
3300
6600
0
Form and Instruction
R-9
Category 4 Discharge Plan
Discharge Notification (Form R-2) - Current UAC Portal
Modified
146100
24837
0
Form and Instruction
R-2
Discharge Notification
Program Exit Processing (Form R-10) - Modernized UAC Portal
Modified
146100
36525
0
Form and Instruction
R-10
Program Exit Processing - Modernized UAC Portal
Release Request (Form R-4) - Current UAC Portal - Care Provider
Modified
129000
54180
0
Form and Instruction
R-4
Release Request - Current UAC Portal Version
Release Request (Form R-4) - Current UAC Portal - Case Coordinator
Modified
128520
42412
0
Form and Instruction
R-4
Release Request - Current UAC Portal Version
Release Request (Form R-4) - Modernized UAC Portal - Care Provider
Modified
129000
74820
0
Form and Instruction
R-4
Release Request - Modernized UAC Portal Version
Release Request (Form R-4) - Modernized UAC Portal - Case Coordinator
Modified
128520
64260
0
Form and Instruction
R-4
Release Request - Modernized UC Portal Version
Safety and Well-Being Call (R-6) - Current Excel - Child
Removed
0
0
0
Form and Instruction
R-6
Safety and Well-Being Call Report - Current Excel Version
Safety and Well-Being Call (R-6) - Current Excel - PRS Provider
Removed
0
0
0
Form and Instruction
R-6
Safety and Well-Being Call Report - Current Excel Version
Safety and Well-Being Call (R-6) - Current Excel - Sponsor
Removed
0
0
0
Form and Instruction
R-6
Safety and Well-Being Call Report - Current Excel Version
Safety and Well-Being Call (R-6) - Modernized UC Portal - Child
Removed
0
0
0
Form and Instruction
R-6
Safety and Well-Being Call Report - Modernized UC Portal
Safety and Well-Being Call (R-6) - Modernized UC Portal - PRS Provider
Removed
0
0
0
Form and Instruction
R-6
Safety and Well-Being Call Report - Modernized UC Portal
Safety and Well-Being Call (R-6) - Modernized UC Portal - Sponsor
Removed
0
0
0
Form and Instruction
R-6
Safety and Well-Being Call Report - Modernized UC Portal
Verification of Release (Form R-1)
Unchanged
128400
21828
0
Form and Instruction
R-1
Verification of Release
Total burden requested under this ICR:
938940
325462
0
To view an IC, click on IC Title
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