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Federal forms, ICRs, and supporting documents

Information Collection Request

Program Reporting and Performance Standards System for Indian and Native American Programs Under Title I, Section 166 of the Workforce Innovation and Opportunity Act

ICR 201608-1205-003 · OMB 1205-0422 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form ETA 9084 Comprehensive Services Program report (Form ETA-9084) (Not-for-Profit Grantees) Form and Instruction Modified Available
TEGL_11-15.pdf Supplementary Document Uploaded 2016-01-19 Available
1205-0422 Supporting Statement_FINAL 9.30.16.doc Supporting Statement A Uploaded 2016-09-30 Available
IC Document Collections
IC IDCollectionTypeStatusForm
45442 Supplemental Youth Services Program Report (Tribal Govermment Grantees) Instruction Modified
207054 Standardized Participant Information Record (Tribal Government Grantees) Instruction Modified
207053 Standardized Participant Information Record (Not-for-Profit Grantees) Instruction Modified
207052 Comprehensive Services Program report (Form ETA-9084) (Not-for-Profit Grantees) Form and Instruction Modified
192308 Standardized Participant Information Record (Individual Participants) Instruction Modified
13267 Comprehensive Services Program Report and Supplemental Youth Services Report (Forms ETA-9084 and ETA-9085) (Tribal Government Grantees) Instruction Modified
ICR Details
1205-0422 201608-1205-003
Historical Active 201511-1205-002
DOL/ETA 012-05-01-02-02-2025-00.
Program Reporting and Performance Standards System for Indian and Native American Programs Under Title I, Section 166 of the Workforce Innovation and Opportunity Act
Revision of a currently approved collection   No
Regular
Approved without change 01/23/2017
Retrieve Notice of Action (NOA) 09/30/2016
  Inventory as of this Action Requested Previously Approved
01/31/2020 36 Months From Approved 01/31/2017
24,170 0 28,110
48,686 0 53,611
0 0 0
OMB Control No. 1205-0422 contains two forms: ETA 9084, Comprehensive Services Program, and ETA 9085, Supplemental Youth Services Program. It also includes standard data elements for participants, the basis of the current performance standards system for WIOA section 166 grantees. ETA 9084 is completed by both tribal and non-profit private sector grantees. ETA 9085 is completed only by tribal grantees.
PL: Pub.L. 105 - 220 166 Name of Law: Workforce Innovation and Opportunity Act (WIOA) of 2014
  
None
Not associated with rulemaking
  81 FR 23752 04/22/2016
81 FR 67391 09/30/2016
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 24,170 28,110 0 0 -3,940 0
Annual Time Burden (Hours) 48,686 53,611 0 0 -4,925 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
Estimates have been updated based on recent data and trends. The previous submission PY 11 Actual National Participant Count total 13,649, which estimated 2.4 hours per record. The current submission reflects PY 14 Actual National Participant Count total 11,679.
$7,064
No
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.
09/30/2016