# Proposed Information Collection Activity; Office of Refugee Resettlement Unaccompanied Refugee Minors Program Application and Withdrawal of Application or Declination of Placement Form (OMB #0970-0550)
**AGENCY:**
Office of Refugee Resettlement, Administration for Children and Families (ACF), Department of Health and Human Services (HHS).
**ACTION:**
Request for public comments.
**SUMMARY:**
The Office of Refugee Resettlement (ORR) is requesting a three-year extension with revisions of the Unaccompanied Refugee Minors (URM) Program Application and Withdrawal of Application or Declination of Placement Form (OMB #0970-0550, expiration 08/31/2023). Proposed revisions include additional instructions, a small number of new questions, dropping a few questions, and rephrasing existing questions.
**DATES:**
*Comments due within 60 days of publication.* In compliance with the requirements of the Paperwork Reduction Act of 1995, ACF is soliciting public comment on the specific aspects of the information collection described above.
**ADDRESSES:**
You can obtain copies of the proposed collection of information and submit comments by emailing *[email protected].* Identify all requests by the title of the information collection.
**SUPPLEMENTARY INFORMATION:**
*Description:* The URM Program Application is completed on behalf of unaccompanied children in the United States who are applying for entry into the URM Program. The application includes biographical data and information on the child's needs to support placement efforts. The Withdrawal of Application or Declination of Placement Form is completed when a child is no longer interested in entering the URM Program or is not interested in entering the placement they were offered.
*Respondents:* Case managers, attorneys, or other representatives working with unaccompanied children who are eligible for the URM Program.
| Instrument | Total | Total | Average | Total burden hours | Annual burden hours |
| --- | --- | --- | --- | --- | --- |
| Unaccompanied Refugee Minors Program Application | 450 | 3 | 1.5 | 2,025 | 675 |
| Withdrawal of Application or Declination of Placement Form | 50 | 3 | 0.2 | 30 | 10 |
*Estimated Total Annual Burden Hours:* 685.
*Comments:* The Department specifically requests comments on (a) whether the proposed collection of information is necessary for the proper performance of the functions of the agency, including whether the information shall have practical utility; (b) the accuracy of the agency's estimate of the burden of the proposed collection of information; (c) the quality, utility, and clarity of the information to be collected; and (d) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques or other forms of information technology. Consideration will be given to comments and suggestions submitted within 60 days of this publication.
*Authority:* 8 U.S.C. 1522(d).
John M. Sweet, Jr.,
ACF/OPRE Certifying Officer.