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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:
1205-0422
ICR Reference No:
201608-1205-003
Status:
Historical Active
Previous ICR Reference No:
201511-1205-002
Agency/Subagency:
DOL/ETA
Agency Tracking No:
012-05-01-02-02-2025-00.
Title:
Program Reporting and Performance Standards System for Indian and Native American Programs Under Title I, Section 166 of the Workforce Innovation and Opportunity Act
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
01/23/2017
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/30/2016
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2020
36 Months From Approved
01/31/2017
Responses
24,170
0
28,110
Time Burden (Hours)
48,686
0
53,611
Cost Burden (Dollars)
0
0
0
Abstract:
OMB Control No. 1205-0422 contains two forms: ETA 9084, Comprehensive Services Program, and ETA 9085, Supplemental Youth Services Program. It also includes standard data elements for participants, the basis of the current performance standards system for WIOA section 166 grantees. ETA 9084 is completed by both tribal and non-profit private sector grantees. ETA 9085 is completed only by tribal grantees.
Authorizing Statute(s):
PL:
Pub.L. 105 - 220 166
Name of Law: Workforce Innovation and Opportunity Act (WIOA) of 2014
Citations for New Statutory Requirements:
None
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:
81 FR 23752
04/22/2016
30-day Notice:
Federal Register Citation:
Citation Date:
81 FR 67391
09/30/2016
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
6
IC Title
Form No.
Form Name
Comprehensive Services Program Report and Supplemental Youth Services Report (Forms ETA-9084 and ETA-9085) (Tribal Government Grantees)
9085, ETA 9085, ETA 9084
General Reporting Instructions for the Supplemental Youth Services Program Report
,
General Reporting Instructions for the Comprehensive Services Program Report and Standardized Participant Information Record Data
,
Summer Youth Report Form
Comprehensive Services Program report (Form ETA-9084) (Not-for-Profit Grantees)
ETA 9084
General Reporting Instructions for the Comprehensive Services Program Report ( and Standardized Participant Information Record Data
Standardized Participant Information Record (Individual Participants)
Standardized Participant Information Record (Not-for-Profit Grantees)
Standardized Participant Information Record (Tribal Government Grantees)
Supplemental Youth Services Program Report (Tribal Govermment Grantees)
ETA 9084
General Reporting Instructions for the Comprehensive Services Program Report and Standardized Participant Information Record Data
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
24,170
28,110
0
0
-3,940
0
Annual Time Burden (Hours)
48,686
53,611
0
0
-4,925
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:
Estimates have been updated based on recent data and trends. The previous submission PY 11 Actual National Participant Count total 13,649, which estimated 2.4 hours per record. The current submission reflects PY 14 Actual National Participant Count total 11,679.
Annual Cost to Federal Government:
$7,064
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:
Walter Parker 202 693-2778 parker.walter@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:
09/30/2016
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