View Information Collection (IC)

View Information Collection (IC)

IC Title:	WIOA Annual State Performace Reporting	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 667

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA-9169	WIOA Statewide and Local Performance Report Template and Specifications	Appendix C - ETA-9169 WIOA Statewide and Local Performance Report Template and Specifications FINAL.xlsx		Yes	Yes	Fillable Fileable
Instruction			Appendix D - Periods for Reporting Annuall and Quarterly FINAL.xlsx		Yes	No	Printable Only
Instruction			Appendix E - Instructions - WIOA Wage Conversion Chart - 4.20.2016 FINAL.xlsx		Yes	No	Printable Only

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: 208	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 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	208	208	0	0	0	0
Annual IC Time Burden (Hours)	928	928	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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