Information Collection

Petition For Adjustment Assistance/solicitud De Assistencia Para Adjuste

IC 121061 under ICR 198510-1205-003 · OMB 1205-0192.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	PETITION FOR ADJUSTMENT ASSISTANCE/SOLICITUD DE ASSISTENCIA PARA ADJUSTE	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	ETA-8569	No	No
Form	8559	No	No
Form	(SPANISH)	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	125	125
Annual IC Cost Burden (Dollars)	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.