View Information Collection (IC)

View Information Collection (IC)

IC Title:	ETA-9042, 9042a	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA 9042	Petition for TAA	ETA-9042 Petition for TAA - English.docx		Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9042	Petition for TAA Spanish	ETA-9042 Petition for TAA - Spanish.docx		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: 1,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

	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	1,200	0	996	0	0	204
Annual IC Time Burden (Hours)	400	0	332	0	0	68
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
WepApp Test Petition	ETA-9042 Webapp Test Petition.pdf	09/10/2020
EBSS Petition Screen Shots	ETA-9042 EBSS Petition Screenshots.docx	09/10/2020

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