OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

WIOA Statewide Performance Report Template and WIOA Local Performance Report Template IC (ETA-9169)

IC 221306 under ICR 202509-1205-010 · OMB 1205-0526.

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

View Information Collection (IC)

WIOA Statewide Performance Report Template and WIOA Local Performance Report Template IC (ETA-9169)
 
Yes Unchanged
 
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 Form 9169 Statewide Performance Report ETA_9169 CLEAN 2.6.2025.xlsx Yes Yes Fillable Fileable

Workforce Management Training and Employment

 

249 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved 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

Title Document Date Uploaded
WOIA Statewide and Local Performance Report - track changes ETA_9169 2.7.24.xlsx 02/09/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].