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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Statement Regarding Benefit Claim for Days Worked
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
20 CFR 322.4
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
UI-48 (08-14)
Statement Regarding Benefits Claimed for Days Worked
Form UI-48 (08-14).pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Litigation and Judicial Activities
Subfunction:
Resolution Facilitation
Privacy Act System of Records
Title:
RRB 6; Unemployment Insurance Record File
FR Citation:
79 FR 58874
Number of Respondents:
14
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
14
0
0
0
0
14
Annual IC Time Burden (Hours)
3
0
0
0
0
3
Annual IC Cost Burden (Dollars)
0
0
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.
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