Information Collection

Supplemental Youth Services Program Report (ETA 9085)

IC 45442 under ICR 201912-1205-009 · OMB 1205-0422.

Documents and Forms

Document Name Document Type
Form ETA-9085 Supplemental Youth Services Program Report (ETA 9085) Form
ETA-9085 INDIAN AND NATIVE AMERICAN YOUTH PROGRAM ANNUAL / SEMI-A ETA Form 9085.pdf Form
ETA-9085 INDIAN AND NATIVE AMERICAN YOUTH PROGRAM ANNUAL / SEMI-A ETA Form 9085 and Instructions.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Supplemental Youth Services Program Report (ETA 9085)	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 683.300 20 CFR 684

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA-9085	INDIAN AND NATIVE AMERICAN YOUTH PROGRAM ANNUAL / SEMI-ANNUAL REPORT	ETA Form 9085.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9085	INDIAN AND NATIVE AMERICAN YOUTH PROGRAM ANNUAL / SEMI-ANNUAL REPORT	ETA Form 9085 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: 73	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	146	-178	324
Annual IC Time Burden (Hours)	292	-7,484	7,776
Annual IC Cost Burden (Dollars)	15,085	15,085	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.