Information Collection

Benefit Accuracy Measurement: Businesses, Farms, and non-profits

IC 204955 under ICR 201308-1205-003 · OMB 1205-0245.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0245 can be found here:

Documents and Forms

Document Name Document Type
ET 395, 5th edition 9 2012.doc Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Benefit Accuracy Measurement: Businesses, Farms, and non-profits	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 602

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			ET 395, 5th edition 9 2012.doc		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 77,626	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Farms, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	77,626	77,626
Annual IC Time Burden (Hours)	100,914	100,914
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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