Information Collection

ETA 9162 Reporting for Random Audit Activity

IC 201532 under ICR 201208-1205-003 · OMB 1205-0495.

Documents and Forms

Document Name Document Type
Form ETA 9162 ETA 9162 Reporting for Random Audit Activity Form and Instruction
ETA 9162 Reporting Instrucitons for Random Audit Reporting instructions for 1205-0495 ETA9162 Random Audit.doc Form and Instruction
Sampling Procedures for EUC Audits.doc Sampling Procedures 5 8 2012 IC Document
WS Sample Selection v2.xlsx sampling selection IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	ETA 9162 Reporting for Random Audit Activity	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 and Instruction	ETA 9162	Reporting Instrucitons for Random Audit	Reporting instructions for 1205-0495 ETA9162 Random Audit.doc		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	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	212	0	212
Annual IC Time Burden (Hours)	636	-8,480	9,116
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Sampling Procedures 5 8 2012	Sampling Procedures for EUC Audits.doc	05/09/2012
sampling selection	WS Sample Selection v2.xlsx	05/09/2012

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