Information Collection

Unemployment Insurance Trust Fund Activity

IC 12998 under ICR 202112-1205-008 · OMB 1205-0154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0154 can be found here:

Documents and Forms

Document Name Document Type
Form ETA 2112 Unemployment Insurance Trust Fund Activity Form
ETA 2112 UI Financial Transaction Summary SectionII_FundManagementActivity_ETA 2112.docx Form
ETA 2112 UI Financial Transaction Summary SectionII_FundManagementActivity_ETA 2112.docx Form
ETA 8401 Monthly Analysis of Benefit Payment Account SectionIII_BankingActivity_ETA 8401.docx Form
ETA 8401 Monthly Analysis of Benefit Payment Account SectionIII_BankingActivity_ETA 8401.docx Form
ETA 8403 Summary of Financial Transactions SectionIII_BankingActivity_ETA 8403.docx Form
ETA 8403 Summary of Financial Transactions SectionIII_BankingActivity_ETA 8403.docx Form
ETA 8405 Monthly Analysis of Clearing Account SectionIII_BankingActivity_ETA 8405.docx Form
ETA 8405 Monthly Analysis of Clearing Account SectionIII_BankingActivity_ETA 8405.docx Form
ETA 8413 Income Expense Analysis, Unemployment Compensation Fund SectionIII_BankingActivity_ETA 8413.docx Form
ETA 8413 Income Expense Analysis, Unemployment Compensation Fund SectionIII_BankingActivity_ETA 8413.docx Form
ETA 8414 Income Expense Analysis, Unemployment Compensation Fund SectionIII_BankingActivity_ETA 8414.docx Form
ETA 8414 Income Expense Analysis, Unemployment Compensation Fund SectionIII_BankingActivity_ETA 8414.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Unemployment Insurance Trust Fund Activity	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 601.5(a)(1)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA 2112	UI Financial Transaction Summary	SectionII_FundManagementActivity_ETA 2112.docx	Yes	Yes	Fillable Fileable
Form	ETA 8401	Monthly Analysis of Benefit Payment Account	SectionIII_BankingActivity_ETA 8401.docx	Yes	Yes	Fillable Fileable
Form	ETA 8403	Summary of Financial Transactions	SectionIII_BankingActivity_ETA 8403.docx	Yes	Yes	Fillable Fileable
Form	ETA 8405	Monthly Analysis of Clearing Account	SectionIII_BankingActivity_ETA 8405.docx	Yes	Yes	Fillable Fileable
Form	ETA 8413	Income Expense Analysis, Unemployment Compensation Fund Benefit Account	SectionIII_BankingActivity_ETA 8413.docx	Yes	Yes	Fillable Fileable
Form	ETA 8414	Income Expense Analysis, Unemployment Compensation Fund Clearing Account	SectionIII_BankingActivity_ETA 8414.docx	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,498	3,498
Annual IC Time Burden (Hours)	1,749	1,749
Annual IC Cost Burden (Dollars)	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.