View Information Collection (IC)

View Information Collection (IC)

IC Title:	ETA Reporting Requirements for Programs reporting on ETA 9130	Agency IC Tracking Number:	0461-0408

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 97.41 29 CFR 95.52

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA 9130	Financial Status Report	ETa-9130-Form.pdf		Yes	Yes	Fillable Fileable
Instruction			9130-Instructions-Basic final..docx		Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9130-A	Employment Services - Unemployment Insurance Financial Report	es_ui.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9130 B	National Farmworker Jobs Program Financial Report	farmworker.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9130 C	Older Worker Program	older worker.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 D	Indian and Native American Program	inap.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 YL	Local Youth Program, WIA	local youth.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 AL	Local Adult Program, WIA	local adult.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 DV	Local Dislocated Worker	local dw.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	eta 9130 YS	Statewide Youth	state youth.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 AD	Statewide Adult WIA	state adult.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 DV	Statewide Dislocated Worker	state dw.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 DWR	Rapid Response, Statewide, WIA	rapid response.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 848	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 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	3,392	0	0	0	0	3,392
Annual IC Time Burden (Hours)	1,696	0	0	-1,696	0	3,392
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Web Page	Financial Reporting.mht	11/26/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.