Information Collection

Work Site Description (existing grantees)

IC 201498 under ICR 202108-1205-004 · OMB 1205-0464.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0464 can be found here:

Documents and Forms

Document Name Document Type
Form ETA 9143 Work Site Description (existing grantees) Form and Instruction
ETA 9143 Work Site Description and Annual Housing Census Forms ETA-9143 Work Site Description and AHC forms_FINAL 7.20.18.pdf Form and Instruction
ETA 9143 Work Site Description and Annual Housing Census Forms ETA-9143 Work Site Description and AHC forms_FINAL 7.20.18.pdf Form and Instruction
ETA 9143 Worksite Description and Annual Housing Census Form YB ETA-9143 and AHC Form_4.12.docx Form and Instruction
ETA 9143 Worksite Description and Annual Housing Census Form YB ETA-9143 and AHC Form_4.12.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Work Site Description (existing grantees)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA 9143	Work Site Description and Annual Housing Census Forms	ETA-9143 Work Site Description and AHC forms_FINAL 7.20.18.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9143	Worksite Description and Annual Housing Census Form	YB ETA-9143 and AHC Form_4.12.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 210	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	210	-210	420
Annual IC Time Burden (Hours)	105	-105	210
Annual IC Cost Burden (Dollars)	0	0	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.