Information Collection

Program Status Summary

IC 221736 under ICR 201602-1205-003 · OMB 1205-0425.

Documents and Forms

Document Name Document Type
Form ETA 9095 Program Status Summary Form and Instruction
ETA 9095 NFJP Program Status Summary Report FINAL_NFJP PSS Form 9095 2.26.16.docx www.doleta.gov/MSFW/pdf/Program-Status-Report-Form-9095.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Program Status Summary	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 9095	NFJP Program Status Summary Report	FINAL_NFJP PSS Form 9095 2.26.16.docx	http://www.doleta.gov/MSFW/pdf/Program-Status-Report-Form-9095.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: 52	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	208	208
Annual IC Time Burden (Hours)	3,536	3,536
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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