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Federal forms, ICRs, and supporting documents

Information Collection

States/Territories Reporting to the Federal Government IC (ETA 9169)

IC 221306 under ICR 202203-1205-001 · OMB 1205-0526.

Documents and Forms
Document Name
Document Type
Instruction
Instruction
Instruction
Instruction
Form
Form
Information Collection (IC) Details

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States/Territories Reporting to the Federal Government IC (ETA 9169)
 
Yes Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 677

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Instructions - WIOA Wage Conversion Chart - 123020.xlsx Yes No Printable Only
Instruction Effectiveness in Serving Employers Specs - 123020.docx Yes No Printable Only
Form ETA 9169 WIOA Statewide and Local Performance Report Template ETA_9169 031022.xlsx Yes Yes Fillable Fileable

Workforce Management Training and Employment

 

249 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 249 0 0 0 0 249
Annual IC Time Burden (Hours) 1,110 0 0 0 0 1,110
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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