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Federal forms, ICRs, and supporting documents

Information Collection Request

APPLICATION FOR AWARD OF EXEMPLARY REHABILITATION CERTIFICATE

ICR 198010-1205-004 · OMB 1205-0124 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
120847 APPLICATION FOR AWARD OF EXEMPLARY REHABILITATION CERTIFICATE Form Migrated
ICR Details
1205-0124 198010-1205-004
Historical Active
DOL/ETA
APPLICATION FOR AWARD OF EXEMPLARY REHABILITATION CERTIFICATE
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/17/1980
Retrieve Notice of Action (NOA) 10/30/1980
  Inventory as of this Action Requested Previously Approved
12/31/1982 12/31/1982
250 0 0
188 0 0
0 0 0
NEEDED TO DETERMINE IF THE ERC SHOULD BE AWARDED. CERTIFICATES ARE AWARDED TO VETERANS WITH GENERAL OR OTHER THAN HONORABLE DISCHARGES WHO HAVE DEMONSTRATED EXEMPLARY CONDUCT DURING THE 3 YEARS PRIOR TO APLICATION. THE CERTIFICATE DOES NOT AFFECT, SUPERSEDE, OR CHANGE THE PERSON'S DISCHARGE IN ANY WAY.
None
None
No
1
IC Title Form No. Form Name
APPLICATION FOR AWARD OF EXEMPLARY REHABILITATION CERTIFICATE ETA 752, ETA 753
  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 250 0 0 250 0 0
Annual Time Burden (Hours) 188 0 0 188 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  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.
10/30/1980