Information Collection

Pay-for-Performance Report

IC 221265 under ICR 201710-1205-004 · OMB 1205-0521.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0521 can be found here:

Documents and Forms

Document Name Document Type
Form ETA-9174 Pay-for-Performance Report Pay-for-Performance Report Form and Instruction
WIPS Grantee Quick Start Guide v0.2.pdf Instruction
WIPS Quick Ref Guide v0.6.pdf Instruction
ETA-9174 Pay-for-Performance Report ETA-9174_FINAL 10.3.17.xlsx Form and Instruction
ETA-9174_(changes) 10.3.17.xlsx Pay-for-Performance Report IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Pay-for-Performance Report	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 677

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA-9174	Pay-for-Performance Report	ETA-9174_FINAL 10.3.17.xlsx	Yes	Yes	Fillable Fileable
Instruction			WIPS Quick Ref Guide v0.6.pdf	Yes	Yes	Fillable Fileable
Instruction			WIPS Grantee Quick Start Guide v0.2.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: 57	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	Previously Approved
Annual Number of Responses for this IC	57	0	57
Annual IC Time Burden (Hours)	1,425	-79,800	81,225
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Pay-for-Performance Report	ETA-9174_(changes) 10.3.17.xlsx	01/09/2018

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