Information Collection

RExO participant survey at 36 months

IC 197890 under ICR 201105-1205-003 · OMB 1205-0498.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0498 can be found here:

Documents and Forms

Document Name Document Type
Appendix_B_survey, early bird 5 23 2012.docx Other-survey
Appendix_B_survey,regular 5 23 2012.docx Other-survey
Appendix_D_Agree_to_participate_.doc Agree to Participate IC Document
RExO_ADVANCE_LETTER 5 23 2012.doc Advance Letter IC Document
RExO_ADVANCE_LETTER, without early bird incentive, 6.1.2012.doc advance letter without early bird incentive IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	RExO participant survey at 36 months	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey			Appendix_B_survey, early bird 5 23 2012.docx		Yes	Yes	Fillable Fileable
Other-survey			Appendix_B_survey,regular 5 23 2012.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: DOL/ETA-15, published April 8, 2002	FR Citation: 67 FR 16898

Number of Respondents: 3,262	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,262	3,262
Annual IC Time Burden (Hours)	1,631	1,631
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Agree to Participate	Appendix_D_Agree_to_participate_.doc	01/20/2012
Advance Letter	RExO_ADVANCE_LETTER 5 23 2012.doc	05/23/2012
advance letter without early bird incentive	RExO_ADVANCE_LETTER, without early bird incentive, 6.1.2012.doc	06/01/2012

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