Information Collection Request

Services for Unaccompanied Alien Children with Disabilities

ICR 202509-0970-007 · OMB 0970-0643 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form S-25 Individual 504 Service Plan Form and Instruction Unchanged Repair queued
Form S-25 Individual 504 Service Plan (Form S-25) – Care Provider Case Manager Form and Instruction Unchanged Repair queued
Form S-25 Individual 504 Service Plan Form and Instruction Unchanged Repair queued
Form S-25 Individual 504 Service Plan (Form S-25) – Child Form and Instruction Unchanged Repair queued
Nonsub Memo_0970-0643_Disabilities_002_DRAFT (10.14.25).docx Justification for No Material/Nonsubstantive Change Uploaded 2025-10-28 Repair queued
ORR-6 0970-0036 Supporting Statement 3-year renew req_7.13.22.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-10-23 Available
Attachment A - Individualized Section 504 Service Plan (Form S-25) Appendix Crosswalk (10.14.25).xlsx Supplementary Document Uploaded 2025-10-15 Repair queued
Attachment A - Individualized Section 504 Service Plan (Form S-25) Appendix Crosswalk (10.14.25).xlsx Supplementary Document Uploaded 2025-10-15 Repair queued
Individualized Section 504 Service Plan (Form S-25) Appendix (aka Disabilities Diagnosis Report) (10.14.25).docx Supplementary Document Uploaded 2025-10-15 Repair queued
Individualized Section 504 Service Plan (Form S-25) Appendix (aka Disabilities Diagnosis Report) (10.14.25).docx Supplementary Document Uploaded 2025-10-15 Repair queued
SSA Attachment A_0970-NEW_Disabilities_001_CLEAN + OGC_SH_ FINAL.docx Supplementary Document Uploaded 2025-04-11 Repair queued
SSA Attachment A_0970-NEW_Disabilities_001_CLEAN + OGC_SH_ FINAL.docx Supplementary Document Uploaded 2025-04-11 Repair queued
SSA_0970-0643_Disabilities_10.15.25 CLEAN.docx Supporting Statement A Uploaded 2025-10-15 Available
SSA_0970-0643_Disabilities_10.15.25 CLEAN.docx Supporting Statement A Uploaded 2025-10-15 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
274814 Individual 504 Service Plan (Form S-25) – Care Provider Case Manager Form and Instruction UnchangedIndividual 504 Service Plan
274814 Individual 504 Service Plan (Form S-25) – Care Provider Case Manager Form and Instruction Unchanged
274813 Individual 504 Service Plan (Form S-25) – Child Form and Instruction UnchangedIndividual 504 Service Plan
274813 Individual 504 Service Plan (Form S-25) – Child Form and Instruction Unchanged
ICR Details
0970-0643 202509-0970-007
Historical Active 202504-0970-003
HHS/ACF ORR - UAC Bureau
Services for Unaccompanied Alien Children with Disabilities
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved with change 10/28/2025
Retrieve Notice of Action (NOA) 10/23/2025
  Inventory as of this Action Requested Previously Approved
06/30/2028 06/30/2028 06/30/2028
4,100 0 4,100
10,300 0 10,300
0 0 0

The Services for Unaccompanied Alien Children (UAC) with Disabilities information collection contains one instrument that allows the Office of Refugee Resettlement (ORR) to provide individualized care to children identified as having a disability. The collection was last approved by OMB on June 11, 2025 and the current expiration date is June 30, 2028. ORR is proposing revisions to the Individualized Section 504 Service Plan (Form S-25). This plan is required by the Lucas R. Disabilities Settlement Agreement (Case No. 2:18-CV-05741 DMG PLA). The form is completed by care providers alongside a qualified assessment team who collaboratively develop an individualized plan for the child. In addition, care providers must continuously update this form to reflect any changes in the service plan and to provide updates on the progress of the home study and post-release services planning.

US Code: 8 USC 1232 Name of Law: William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008 (TVPRA)
   US Code: 6 USC 279 Name of Law: Homeland Security Act (HSA)
  
None

Not associated with rulemaking

  89 FR 60428 07/25/2024
90 FR 17823 04/29/2025
Yes

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,100 4,100 0 0 0 0
Annual Time Burden (Hours) 10,300 10,300 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This is a new information collection.

$577,249
No
    Yes
    Yes
No
No
No
No
Molly Buck 202 205-4724 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/23/2025