Information Collection

Trade Adjustment Assistance/NAFTA Financial Status/Request for Funds Report

IC 13089 under ICR 200307-1205-004 · OMB 1205-0275.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	Trade Adjustment Assistance/NAFTA Financial Status/Request for Funds 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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA-9023				Yes	Yes
Form	SF-269				Yes	Yes

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: 50 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,040	540	500
Annual IC Time Burden (Hours)	1,300	300	1,000
Annual IC Cost Burden (Dollars)	33,946,000	33,920,000	26,000

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.