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Federal forms, ICRs, and supporting documents

Information Collection

Statement of Expenditures and Financial Adjustment of Federal Funds for Unemployment Compensation for Federal Employees and Ex-Servicemembers

IC 43787 under ICR 202501-1205-002 · OMB 1205-0162.

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

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Statement of Expenditures and Financial Adjustment of Federal Funds for Unemployment Compensation for Federal Employees and Ex-Servicemembers
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form ETA 191 Statement of Expenditures and Financial Adjustments of Federal Funds for Unemployment Compensation for Federal Employees and Ex-Servicemember ETA 191 508-compliant.pdf Yes Yes Fillable Fileable
Instruction SectionII_FundManagementActivity_ETA 191 clean copy_2025.docx Yes Yes Fillable Fileable

Income Security Unemployment Compensation

 

53 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 212 0 0 0 0 212
Annual IC Time Burden (Hours) 1,272 0 0 0 0 1,272
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Tracked ETA 191 Instructions SectionII_FundManagementActivity_ETA 191 - tracked.docx 04/27/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.