Information Collection

Participant Reporting

IC 221308 under ICR 201906-1205-002 · OMB 1205-0526.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0526 can be found here:

Documents and Forms

Document Name Document Type
Instructions - WIOA Wage Conversion Chart - 4.20.2016 FINAL.xlsx Instruction
ETA-9170 WIOA PIRL ETA-9170_FINAL 12.4.17.xlsx Form
ETA-9170_(changes) 12.4.17.xlsx Amended WIOA PIRL_ETA-9170 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Participant Reporting	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: Unchanged

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Instructions - WIOA Wage Conversion Chart - 4.20.2016 FINAL.xlsx		Yes	No	Printable Only
Form	ETA-9170	WIOA PIRL	ETA-9170_FINAL 12.4.17.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 19,102,174	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Previously Approved
Annual Number of Responses for this IC	19,102,174	19,102,174
Annual IC Time Burden (Hours)	4,775,544	4,775,544
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Amended WIOA PIRL_ETA-9170	ETA-9170_(changes) 12.4.17.xlsx	12/29/2017

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