Information Collection

Employer Services Activity Report

IC 120586 under ICR 197909-1205-005 · OMB 1205-0024.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0024 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	EMPLOYER SERVICES ACTIVITY REPORT	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	MA 5-20)	No	No
Form	ETA 520	No	No
Form	(FORMERLY	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 52	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	624	24	600
Annual IC Time Burden (Hours)	2,569	169	2,400
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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