OMB control number

U.S. Repatriation Program Forms

OMB 0970-0474 · HHS/ACF.

OMB 0970-0474

The U.S. Repatriation Program (Program) is authorized by Section 1113 of the Social Security Act (42 U.S.C. § 1313) and the assistance provided to mentally ill repatriates found under 24 U.S.C. §§ 321 - 329. This Program also provides services for emergency repatriations which are authorized under Section 1113 and by the extension of the Executive Order (E.O.) precedent, E.O. 12656 (53 CFR 47491). Program regulations are in 45 CFR 211 & 212. The current collection includes eight forms with translations in six languages. The information collected through these forms allows the Office of Human Services Emergency Preparedness and Response (OHSEPR) to fulfill its statutory responsibilities to provide temporary assistance to repatriates. The Program also provides training and technical assistance to states and territories for routine and emergency repatriation. Additionally, OHSEPR provides funding to states for emergency repatriation planning, training, and exercises. In 2025, ACF submitted updates to forms under this collection in response to new Executive Orders. Through that process, OMB requested minor edits to the SSA to align with the updates to the form. Through that revision process the incorrect SSA was inadvertently updated and sent for upload. ACF would like to replace the currently uploaded SSA with the correct version. The correct version matches the data entered in ROCIS in terms of burden estimates and forms approved.

The latest form for U.S. Repatriation Program Forms expires 2027-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 1 Repatriation Training and Technical Assistance Request Form Form
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support - Traditional Chinese Form and Instruction
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support - Spanish Form and Instruction
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support - Simplified Chinese Form and Instruction
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support - Russian Form and Instruction
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support - French Form and Instruction
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support - Arabic Form and Instruction
Form RR-08 Emergency Repatriation Request for Cost Approval and Federal Support Form and Instruction
Form RR-07 Temporary Assistance Extension Request - Traditional Chinese Form and Instruction
Form RR-07 Temporary Assistance Extension Request - Spanish Form and Instruction
Form RR-07 Temporary Assistance Extension Request - Simplified Chinese Form and Instruction
Form RR-07 Temporary Assistance Extension Request - Russian Form and Instruction
Form RR-07 Temporary Assistance Extension Request - French Form and Instruction
Form RR-07 Temporary Assistance Extension Request - Arabic Form and Instruction
Form RR-07 Temporary Assistance Extension Request Form and Instruction
Form RR-06 Refusal of Temporary Assistance - Traditional Chinese Form and Instruction
Form RR-06 Refusal of Temporary Assistance - Spanish Form and Instruction
Form RR-06 Refusal of Temporary Assistance - Simplified Chinese Form and Instruction
Form RR-06 Refusal of Temporary Assistance - Russian Form and Instruction
Form RR-06 Refusal of Temporary Assistance - French Form and Instruction
Form RR-06 Refusal of Temporary Assistance - Arabic Form and Instruction
Form RR-06 Refusal of Temporary Assistance Form and Instruction
Form RR-05 Repatriation Repayment and Privacy Agreement Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request - Traditional Chinese Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request - Spanish Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request - Simplified Chinese Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request - Russian Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request - French Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request - Arabic Form and Instruction
Form RR-04 Routine Repatriation Reimbursement Request Form and Instruction
Form RR-03 Loan Waiver and Deferral Application - Traditional Chinese Form and Instruction
Form RR-03 Loan Waiver and Deferral Application - Spanish Form and Instruction
Form RR-03 Loan Waiver and Deferral Application - Simplified Chinese Form and Instruction
Form RR-03 Loan Waiver and Deferral Application - Russian Form and Instruction
Form RR-03 Loan Waiver and Deferral Application - French Form and Instruction
Form RR-03 Loan Waiver and Deferral Application - Arabic Form and Instruction
Form RR-03 Loan Waiver and Deferral Application Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request - Traditional Chinese Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request - Spanish Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request - Simplified Chinese Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request - Russian Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request - French Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request - Arabic Form and Instruction
Form RR-02 Emergency Repatriation Reimbursement Request Form and Instruction
Form RR-01 Emergency Repatriation Eligibility Application Form and Instruction
Repatriation Post-Training Survey Other-Survey
Repatriation Training and Technical Assistance Request Form Form
Repatriation Training and Technical Assistance Request Form Form
Repatriation State Contact List Other-Contact List
Planning, Training, and Exercise – Budget and Budget Narrative Other-Narrative
Planning, Training, and Exercise – Annual Workplan Other-Workplan
Planning, Training, and Exercise – Project Narrative Other-Narrative
Emergency Repatriation Request for Cost Approval and Federal Support Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support Form and Instruction
Emergency Repatriation Request for Cost Approval and Federal Support Form and Instruction
Temporary Assistance Extension Request Form and Instruction
Temporary Assistance Extension Request Form and Instruction
Temporary Assistance Extension Request Form and Instruction
Temporary Assistance Extension Request Form and Instruction
Temporary Assistance Extension Request Form and Instruction
Temporary Assistance Extension Request Form and Instruction
Temporary Assistance Extension Request Form and Instruction
Temporary Assistance Extension Request Form and Instruction
Refusal of Temporary Assistance Form and Instruction
Refusal of Temporary Assistance Form and Instruction
Refusal of Temporary Assistance Form and Instruction
Refusal of Temporary Assistance Form and Instruction
Refusal of Temporary Assistance Form and Instruction
Refusal of Temporary Assistance Form and Instruction
Refusal of Temporary Assistance Form and Instruction
Refusal of Temporary Assistance Form and Instruction
Repatriation Repayment and Privacy Agreement Form and Instruction
Repatriation Repayment and Privacy Agreement Form and Instruction
Routine Repatriation Reimbursement Request Form and Instruction
Routine Repatriation Reimbursement Request Form and Instruction
Routine Repatriation Reimbursement Request Form and Instruction
Routine Repatriation Reimbursement Request Form and Instruction
Routine Repatriation Reimbursement Request Form and Instruction
Routine Repatriation Reimbursement Request Form and Instruction
Routine Repatriation Reimbursement Request Form and Instruction
Routine Repatriation Reimbursement Request Form and Instruction
Loan Waiver and Deferral Application Form and Instruction
Loan Waiver and Deferral Application Form and Instruction
Loan Waiver and Deferral Application Form and Instruction
Loan Waiver and Deferral Application Form and Instruction
Loan Waiver and Deferral Application Form and Instruction
Loan Waiver and Deferral Application Form and Instruction
Loan Waiver and Deferral Application Form and Instruction
Loan Waiver and Deferral Application Form and Instruction
Emergency Repatriation Reimbursement Request Form and Instruction
Emergency Repatriation Reimbursement Request Form and Instruction
Emergency Repatriation Reimbursement Request Form and Instruction
Emergency Repatriation Reimbursement Request Form and Instruction
Emergency Repatriation Reimbursement Request Form and Instruction
Emergency Repatriation Reimbursement Request Form and Instruction
Emergency Repatriation Reimbursement Request Form and Instruction
Emergency Repatriation Reimbursement Request Form and Instruction
Emergency Repatriation Eligibility Application Form and Instruction
Emergency Repatriation Eligibility Application Form and Instruction

All Historical Document Collections

202602-0970-008 Approved without change	No material or nonsubstantive change to a currently approved collection	2026-02-17
202502-0970-024	No material or nonsubstantive change to a currently approved collection	2025-02-13
202311-0970-008 Approved with change	Revision of a currently approved collection	2023-11-27
202304-0970-011 Approved without change	No material or nonsubstantive change to a currently approved collection	2023-05-01
202204-0970-004 Approved without change	Revision of a currently approved collection	2022-04-12
201903-0970-002 Approved without change	Extension without change of a currently approved collection	2019-03-29
201510-0970-006 Approved with change	New collection (Request for a new OMB Control Number)	2015-11-18

OMB Details

Emergency Repatriation Eligibility Application

Federal Enterprise Architecture: Community and Social Services - Social Services

Form RR-01

Emergency Repatriation Eligibility Application

Fillable Printable

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.