Information Collection

Distribution of Characteristics of the insured Unemployed

IC 12923 under ICR 202407-1205-002 · OMB 1205-0009.

Documents and Forms

Document Name Document Type
Form ETA 203 Distribution of Characteristics of the insured Unemployed Form and Instruction
Att. B 203 Reasoning for 203 report.docx Other-Report
Att. C ETA 203 report cell map.xlsx Other-Report
ETA 203 Characteristics of the Unemployed ETA 401 HB-Report 203.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Distribution of Characteristics of the insured Unemployed	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA 203	Characteristics of the Unemployed	ETA 401 HB-Report 203.docx	Yes	Yes	Fillable Fileable
Other-Report			Att. B 203 Reasoning for 203 report.docx	Yes	Yes	Fillable Printable
Other-Report			Att. C ETA 203 report cell map.xlsx	Yes	Yes	Fillable Printable

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 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	636	0	636
Annual IC Time Burden (Hours)	426	214	212
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.