View Information Collection (IC)

View Information Collection (IC)

IC Title:	Job Service Complaint Reporting (ETA 8429)	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 653.109 20 CFR 658

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA 8429	Complaint Form	ETA 8429 Complaint Form FINAL 2019-09-12.docx		Yes	Yes	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: DOL/ETA-15, published April 8, 2002	FR Citation: 67 FR 16898

Number of Respondents: 3,082	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	3,082	0	0	-418	0	3,500
Annual IC Time Burden (Hours)	6,164	0	0	-836	0	7,000
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
ETA 8429 Tracked Changes	ETA 8429 Complaint Form Proposed Track Changes 2019-09-11.docx	09/16/2019

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