Information Collection

Indian and Native American Welfare-to-Work Program - Report Forms and Instructions

IC 13195 under ICR 200310-1205-001 · OMB 1205-0386.

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Information Collection (IC) Details

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IC Title:	Indian and Native American Welfare-to-Work Program - Report Forms and Instructions	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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA-9069				Yes	Yes
Form	ETA-9069-1				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 3 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	6,920	6,920
Annual IC Time Burden (Hours)	22,680	22,680
Annual IC Cost Burden (Dollars)	396,000	396,000

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.