Form S-9 Assessment for Risk - UC Path Version

Assessment for Risk (Form S-9)
Data Entry Window

Basic Information Tab

[PHOTO]

The remaining questions in this section should only be asked of children ages 10 and older.

OMB 0970-0553 [valid through MM/DD/YYYY]
THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to allow ORR to reduce the risk that a child or youth is sexually abused or abuses someone else while in ORR custody. Public
reporting burden for this collection of information is estimated to average 0.75 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a mandatory collection
of information (Homeland Security Act, 6 U.S.C. 279). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently
valid OMB control number. If you have any comments on this collection of information please contact UACPolicy@acf.hhs.gov.
UAC-S-9 [Rev. MM/DD/YYYY]

Assignments and Follow-Up Tab

OMB 0970-0553 [valid through MM/DD/YYYY]
THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to allow ORR to reduce the risk that a child or youth is sexually abused or abuses someone else while in ORR custody. Public
reporting burden for this collection of information is estimated to average 0.75 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a mandatory collection
of information (Homeland Security Act, 6 U.S.C. 279). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently
valid OMB control number. If you have any comments on this collection of information please contact UACPolicy@acf.hhs.gov.
UAC-S-9 [Rev. MM/DD/YYYY]

Documents Tab

OMB 0970-0553 [valid through MM/DD/YYYY]
THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to allow ORR to reduce the risk that a child or youth is sexually abused or abuses someone else while in ORR custody. Public
reporting burden for this collection of information is estimated to average 0.75 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a mandatory collection
of information (Homeland Security Act, 6 U.S.C. 279). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently
valid OMB control number. If you have any comments on this collection of information please contact UACPolicy@acf.hhs.gov.
UAC-S-9 [Rev. MM/DD/YYYY]

Documents Data Entry Window

Certification Tab

OMB 0970-0553 [valid through MM/DD/YYYY]
THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to allow ORR to reduce the risk that a child or youth is sexually abused or abuses someone else while in ORR custody. Public
reporting burden for this collection of information is estimated to average 0.75 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a mandatory collection
of information (Homeland Security Act, 6 U.S.C. 279). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently
valid OMB control number. If you have any comments on this collection of information please contact UACPolicy@acf.hhs.gov.
UAC-S-9 [Rev. MM/DD/YYYY]