Information Collection

ETA Reporting Requirements for Programs reporting on ETA 9130

IC 44659 under ICR 201205-1205-006 · OMB 1205-0461.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0461 can be found here:

Documents and Forms

Document Name Document Type
Form ETA 9130 ETA Reporting Requirements for Programs reporting on ETA 9130 Form
9130-Instructions-Basic final..docx Instruction
ETA 9130 Financial Status Report ETa-9130-Form.pdf Form
ETA-9130-A Employment Services - Unemployment Insurance Financial R es_ui.pdf Form and Instruction
ETA-9130 B National Farmworker Jobs Program Financial Report farmworker.pdf Form and Instruction
ETA-9130 C Older Worker Program older worker.pdf Form and Instruction
ETA 9130 D Indian and Native American Program inap.pdf Form and Instruction
ETA 9130 YL Local Youth Program, WIA local youth.pdf Form and Instruction
ETA 9130 AL Local Adult Program, WIA local adult.pdf Form and Instruction
ETA 9130 DV Local Dislocated Worker local dw.pdf Form and Instruction
eta 9130 YS Statewide Youth state youth.pdf Form and Instruction
ETA 9130 AD Statewide Adult WIA state adult.pdf Form and Instruction
ETA 9130 DV Statewide Dislocated Worker state dw.pdf Form and Instruction
ETA 9130 DWR Rapid Response, Statewide, WIA rapid response.pdf Form and Instruction
Financial Reporting.mht Web Page IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	ETA Reporting Requirements for Programs reporting on ETA 9130	Agency IC Tracking Number:	0461-0408

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 97.41 29 CFR 95.52

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA 9130	Financial Status Report	ETa-9130-Form.pdf	Yes	Yes	Fillable Fileable
Instruction			9130-Instructions-Basic final..docx	Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9130-A	Employment Services - Unemployment Insurance Financial Report	es_ui.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9130 B	National Farmworker Jobs Program Financial Report	farmworker.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9130 C	Older Worker Program	older worker.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 D	Indian and Native American Program	inap.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 YL	Local Youth Program, WIA	local youth.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 AL	Local Adult Program, WIA	local adult.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 DV	Local Dislocated Worker	local dw.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	eta 9130 YS	Statewide Youth	state youth.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 AD	Statewide Adult WIA	state adult.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 DV	Statewide Dislocated Worker	state dw.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 DWR	Rapid Response, Statewide, WIA	rapid response.pdf	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 848	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,392	0	3,392
Annual IC Time Burden (Hours)	1,696	-1,696	3,392
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Web Page	Financial Reporting.mht	11/26/2012

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