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Federal forms, ICRs, and supporting documents

Information Collection Request

Employment Assistance Referral Network (EARN) Employer and Provider Enrollment Forms, Employer Job Posting Form, and Employer and Provider Surveys

ICR 200212-1230-001 · OMB 1230-0003 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
14740 Employment Assistance Referral Network (EARN) Employer and Provider Enrollment Forms, Employer Job Posting Form, and Employer and Provider Surveys Form Migrated
ICR Details
1230-0003 200212-1230-001
Historical Active
DOL/ODEP
Employment Assistance Referral Network (EARN) Employer and Provider Enrollment Forms, Employer Job Posting Form, and Employer and Provider Surveys
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 02/10/2003
Retrieve Notice of Action (NOA) 12/09/2002
Approved.
  Inventory as of this Action Requested Previously Approved
02/28/2006 02/28/2006
14,100 0 0
4,655 0 0
0 0 0
EARN is a referral service that links employers with service providers who refer appropriate candidates with disabilities. This information collection will enable ODEP to implement its responsibilities under P.L. 106-554 and Executive Order 13187 by providing necessary information for referrals as well as provide data on the effectiveness of the program.
None
None
No
  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 14,100 0 0 14,100 0 0
Annual Time Burden (Hours) 4,655 0 0 4,655 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
Yes Part B of Supporting Statement
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.
12/09/2002