OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Senior Community Service Employment Program Performance Measurement System

ICR 201601-1205-002 · OMB 1205-0040 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
Form Eta 9120 SCSEP Participant Data Form (State) Form Unchanged Available
Form ETA-9123 SCSEP Exit Form (National) Form Unchanged Repair queued
Form ETA 9123 SCSEP Exit Form (State) Form Unchanged Repair queued
Form ETA-9122 SCSEP Unsubsidized Employment Form (National) Form Unchanged Repair queued
Form ETA-9122 SCSEP Unsubsidized Employment Form (State) Form Unchanged Available
Form ETA 9121 SCSEP Community Service Assignment Form (National) Form Unchanged Repair queued
Form ETA 9121 SCSEP Community Service Assignment Form (State) Form Unchanged Available
Form ETA 9120 SCSEP Participant Data Form (National) Form Unchanged Repair queued
Form ETA-8705 SCSEP Equitable Distribution Report Form Unchanged Available
Form ETA 9124B SCSEP Employer and Host Agency Customer Satisfaction Surveys Form and Instruction Unchanged Repair queued
1205-0040 Non-substantive Change Justification.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-02-05 Repair queued
1205-0040_SupportPartB_FINAL_edited_3-23-2015.doc Supporting Statement B Uploaded 2015-03-23 Repair queued
Approval - Statistical Clearance.3232015.pdf Supplementary Document Uploaded 2015-03-23 Repair queued
1205-0040_SupportPartA_FINAL07-2015.doc Supporting Statement A Uploaded 2015-07-29 Available
IC Document Collections
IC IDCollectionTypeStatusForm
43785 SCSEP Participant Data Form (State) Form Unchanged
215838 Quarterly Narrative Progress Report Other-Quarterly Narrative Progress Report Unchanged
185407 SCSEP Four-Year State Strategy Instruction Modified
181013 SCSEP Exit Form (National) Form Unchanged
181011 SCSEP Exit Form (State) Form Unchanged
181010 SCSEP Unsubsidized Employment Form (National) Form Unchanged
181009 SCSEP Unsubsidized Employment Form (State) Form Unchanged
181008 SCSEP Community Service Assignment Form (National) Form Unchanged
181007 SCSEP Community Service Assignment Form (State) Form Unchanged
180574 SCSEP Participant Data Form (National) Form Unchanged
180499 SCSEP Equitable Distribution Report Form Unchanged
180160 SCSEP Employer and Host Agency Customer Satisfaction Surveys Form and Instruction Unchanged
ICR Details
1205-0040 201601-1205-002
Historical Inactive 201509-1205-002
DOL/ETA
Senior Community Service Employment Program Performance Measurement System
No material or nonsubstantive change to a currently approved collection   No
Regular
Withdrawn and continue 03/15/2016
Retrieve Notice of Action (NOA) 03/01/2016
Prior terms remain in effect. Agency made updates to supporting statement to reflect changes to instruments as well as a notation to reflect the extension of pilot grants through December 2015. After these grants expire, the Department will submit a non-material change request to discontinue the use of these fields in the instruments associated with these grants.
  Inventory as of this Action Requested Previously Approved
08/31/2018 08/31/2018 08/31/2018
232,520 0 232,520
32,922 0 32,922
0 0 0
This information collection contains program performance reports required for monitoring the Senior Community Service Employment Program (SCSEP). The current request is for an extension with the addition of a request for approval of an additional participant data indicator: participants' volunteer efforts.
PL: Pub.L. 109 - 365 501-518 Name of Law: Older Americans Act Amendments of 2006
  
None
Not associated with rulemaking
  79 FR 65705 11/05/2014
80 FR 16457 03/27/2015
No
No
No
As program appropriations decrease, grantees serve fewer participants, which have decreased burden hours. The response data for the three customer satisfaction surveys have also been adjusted downward based on PY 2013 usage statistics. In addition, SCSEP now operates with 72 grantees.
$65,713
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Walter Parker 202 693-2778 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/01/2016