View Information Collection (IC)

View Information Collection (IC)

IC Title:	Gen IC: Health Coverage Tax Credit (HCTC) for Eligible Trade Adjustment Assistance (TAA), Alternative TAA (ATAA) and Reemployment TAA (RTAA) Recipients	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-UIPL Program Letter			1225-0086 UIPL_HCTC Final.doc		Yes	Yes	Fillable Fileable
Other-UIPL HCTC Attachment A			1225-0086 UIPL_HCTC AttachmentA Final.doc		Yes	Yes	Fillable Fileable
Other-UIPL HCTC Attachment B			1225-0086 UIPL_HCTC_AttachmentB Final.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:	FR Citation:

Number of Respondents: 54	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

	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	54	0	54	0	0	0
Annual IC Time Burden (Hours)	1,080	0	1,080	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement: Health Coverage Tax Credit (HCTC) for Eligible Trade Adjustment Assistance (TAA), Alternative TAA (ATAA) and Reemployment TAA (RTAA) Recipients	1225-0086 HCTC UIPL Supplemental Support Statement.docx	10/07/2016

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