Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C)

Services Provided to Unaccompanied Children

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0553 can be found here:

Documents and Forms

Document Name Document Type
Form S-21C Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C) Form and Instruction
Form S-21C Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C) Form and Instruction
S-21C Home Study/Post-Release Service (HS/PRS) Primary Provide HS-PRS Primary Provider Profile (Form S-21C) - UC Path.pdf Form and Instruction
S-21C Home Study/Post-Release Service (HS/PRS) Primary Provide HS-PRS Primary Provider Profile (Form S-21C) - UC Path.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	S-21C	Home Study/Post-Release Service (HS/PRS) Primary Provider Profile	HS-PRS Primary Provider Profile (Form S-21C) - UC Path.pdf		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: 09-80-0321 ORR Division of Children's Services Records	FR Citation: 81 FR 46882

Number of Respondents: 9	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	117	117
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.