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View Information Collection (IC) List
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1205-0172
ICR Reference No:
201010-1205-003
Status:
Historical Active
Previous ICR Reference No:
200709-1205-003
Agency/Subagency:
DOL/ETA
Agency Tracking No:
UPI 012-05-01-05-01-2035-00
Title:
Benefit Appeals Report
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
01/30/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/30/2010
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2014
36 Months From Approved
01/31/2011
Responses
636
0
648
Time Burden (Hours)
1,908
0
648
Cost Burden (Dollars)
0
0
0
Abstract:
Data are used to monitor the benefit appeals process and to develop plans for remedial action. The report is also needed for budgeting and workload data.
Authorizing Statute(s):
PL:
Pub.L. 74 - 271 303(a)(6)
Name of Law: Social Security Act
Citations for New Statutory Requirements:
PL: Pub.L. 110 - 252 Title IV Name of Law: Aupplemental Appropriations Act, 2008
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
75 FR 53983
09/02/2010
30-day Notice:
Federal Register Citation:
Citation Date:
75 FR 74087
11/30/2010
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Benefit Appeals Report
ETA-9130
Section 1 Claimant Activity
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
636
648
0
0
-12
0
Annual Time Burden (Hours)
1,908
648
0
0
1,260
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
The revision in burden reflects the expansion of reporting to accommodate congressionally mandated expansions of benefits through the Emergency Unemployment Compensation 2008 program and the ARRA expansions of the Federal-State Extended Benefit programs. We expect states to submit the ETA 5130 for all three programs for the duration of the extended and emergency programs. Once the recession has ended, it is likely this report will revert to a lower burden level as we resume more typical reporting frequencies. The reduction of one reporting entity reduces the number of annual reports by 12 and corrects an inadvertent error in ROCIS in the previous submission.
Annual Cost to Federal Government:
$0
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Bonnie Naradzay 202-693-3675 Naradzay.Bonnie@dol.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
11/30/2010