Information Collection

Comprehensive Services Program report (Form ETA-9084)

IC 207052 under ICR 201912-1205-009 · OMB 1205-0422.

Documents and Forms

Document Name Document Type
Form ETA-9084 Comprehensive Services Program report (Form ETA-9084) Form
ETA-9084 Comprehensive Services Quarterly Performance Report ETA Form 9084.pdf Form
ETA-9084 Comprehensive Services Quarterly Performance Report ETA Form 9084 and Instructions.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Comprehensive Services Program report (Form ETA-9084)	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 684 20 CFR 683.300

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA-9084	Comprehensive Services Quarterly Performance Report	ETA Form 9084.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9084	Comprehensive Services Quarterly Performance Report	ETA Form 9084 and Instructions.pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: DOL/ETA - 15	FR Citation: 67 FR 16898

Number of Respondents: 111	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	444	280	164
Annual IC Time Burden (Hours)	888	-3,048	3,936
Annual IC Cost Burden (Dollars)	45,874	45,874	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.