Information Collection

Disability Disclosure

IC 200928 under ICR 201606-1205-002 · OMB 1205-0223.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0223 can be found here:

Documents and Forms

Document Name Document Type
Form ETA 671 Section II Disability Disclosure Form
ETA 671 Section II Apprenticeship Registration Form 671 Tear off Form for Disabilitiy Disclosure.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Disability Disclosure	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	ETA 671 Section II	Apprenticeship Registration	Form 671 Tear off Form for Disabilitiy Disclosure.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 89,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	89,000	-50,600	139,600
Annual IC Time Burden (Hours)	7,387	-4,200	11,587
Annual IC Cost Burden (Dollars)	0	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.