OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Statement of Expenditures and Financial Adjustments of Federal Funds for Unemployment Compensation for Federal Employees and Ex-Service Members

ICR 202501-1205-002 · OMB 1205-0162 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form ETA 191 Statement of Expenditures and Financial Adjustment of Federal Funds for Unemployment Compensation for Federal Employees and Ex-Servicemembers Form Modified Available
OMB 1205-0162 Supporting Statement_2025.docx Supporting Statement A Uploaded 2025-01-08 Available
IC Document Collections
IC IDCollectionTypeStatusForm
43787 Statement of Expenditures and Financial Adjustment of Federal Funds for Unemployment Compensation for Federal Employees and Ex-Servicemembers Form Modified
ICR Details
1205-0162 202501-1205-002
Received in OIRA 202204-1205-003
DOL/ETA
Statement of Expenditures and Financial Adjustments of Federal Funds for Unemployment Compensation for Federal Employees and Ex-Service Members
Extension without change of a currently approved collection   No
Regular 05/02/2025
  Requested Previously Approved
36 Months From Approved 06/30/2025
212 212
1,272 1,272
0 0
Federal civilian and military agencies must reimburse the Federal Employees Compensation Account for the amount expended for benefits to former Federal (civilian) employees and ex-servicemembers. The report informs ETA of the amount to bill such agencies.
US Code: 42 USC 503(a)(6) Name of Law: Social Security Act
  
None
Not associated with rulemaking
  89 FR 66145 08/14/2024
90 FR 18871 05/02/2025
No
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 212 212 0 0 0 0
Annual Time Burden (Hours) 1,272 1,272 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$30,681
No
    No
    No
No
No
No
No
Patrice Gibson 202 693-0158 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/02/2025