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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Request for Employment Information
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
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
CA-1027
Request for Employer Information
CA-1027 DOC FOR ROCIS 10-23-09[1].doc
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Unemployment Compensation
Privacy Act System of Records
Title:
DOL/GOVT-1
FR Citation:
58 FR 49556
Number of Respondents:
500
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
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
500
0
0
0
0
500
Annual IC Time Burden (Hours)
125
0
0
0
0
125
Annual IC Cost Burden (Dollars)
235
0
0
25
0
210
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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The .gov means it's official.
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