Information Collection Request

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

ICR 202305-0970-009 · OMB 0970-0550 · Received in OIRA

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0970-0550 can be found here:

Forms and Documents

Document Name	Status
Form 1 Withdrawal of Application or Declination of Placement Form Form	Modified
Form 1 Unaccompanied Refugee Minors Program Application Form	Modified
Supporting Statement A - URM Program Application_mj_clean.docx Supporting Statement A	2023-05-15

IC Document Collections

IC ID	Document Title	Status
241922	Withdrawal of Application or Declination of Placement Form Form	Modified
241921	Unaccompanied Refugee Minors Program Application Form	Modified

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/ACF
OMB Control No	0970-0550
Type of Information Collection	Revision of a currently approved collection
Previous ICR Reference No	202206-0970-012
Agency Tracking No	ORR
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31