View Information Collection (IC)

View Information Collection (IC)

IC Title:	State Recordkeeing	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 677

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Periods for Reporting - Annual and Quarterly FINAL.xlsx		Yes	No	Printable Only
Instruction			Instructions - WIOA Wage Conversion Chart - 4.20.2016 FINAL.xlsx		Yes	No	Printable Only
Form	ETA-9170	WIOA PIRL	ETA 9170 - WIOA PIRL_Final_V22_062716.xlsx		Yes	Yes	Fillable Fileable
Instruction			Effectiveness in Serving Employers Specs - 4.20.2016 FINAL.doc		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: 213	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	16,210,211	16,210,211	0	0	0	0
Annual IC Time Burden (Hours)	4,254,436	4,254,436	0	0	0	0
Annual IC Cost Burden (Dollars)	26,147,067	26,147,067	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.