View Information Collection (IC)

View Information Collection (IC)

IC Title:	Supplemental Youth Services Program Report (Tribal Govermment Grantees)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 652

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			INA-SPIR-Specifications- may 2013.doc		Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9084	General Reporting Instructions for the Comprehensive Services Program Report and Standardized Participant Information Record Data	ETA 9084 General Reporting Instructions September 5 20131final.doc		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: DOL/ETA-15	FR Citation: 67 FR 16898

Number of Respondents: 81	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	324	0	-6,483	-166	0	6,973
Annual IC Time Burden (Hours)	7,776	0	-20,194	-682	0	28,652
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
ETA 9084 Services Program Report Added Fields Yellow Highlighted	ETA 9084 General Reporting Instructions September 5 20131.doc	09/17/2013

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