Information Collection

Employer Services Activity Report

IC 168156 under ICR 198209-1205-020 · OMB 1205-0024.

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	(FORMERLY	No	No
Form	ETA 520	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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	624	0	624
Annual IC Time Burden (Hours)	260	-776	1,036
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.

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