Information Collection

Eta 9055

IC 240795 under ICR 202303-1205-005 · OMB 1205-0359.

Documents and Forms

Document Name Document Type
Form ETA-9055 ETA 9055 Form and Instruction
ETA-9055 Benefits Time Lapse & Quality SectionV_Benefits_TimeLapse_and_Quality_ETA 9055.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	ETA 9055	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-9055	Benefits Time Lapse & Quality	SectionV_Benefits_TimeLapse_and_Quality_ETA 9055.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: 53	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	636	636
Annual IC Time Burden (Hours)	1,272	1,272
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.