View Information Collection (IC)

View Information Collection (IC)

IC Title:	YouthBuild Grantee Quarterly Reports and Housing Site Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 672

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA 9143, Part C	Annual Housing Census	Work Site with ANNUAL HOUSING CENSUS, Part C.xls		Yes	Yes	Fillable Fileable Signable
Form	ETA 9143 Parts A and B	Work Site Description Parts A and B	Work Site Description final Parts A and B.xls		Yes	Yes	Fillable Fileable Signable
Form and Instruction	ETA 9136	MIS System, Quarterly Reports	Revised screenshot of YB PRA statement and exp date.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: 220	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	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	2,035	0	220	0	0	1,815
Annual IC Time Burden (Hours)	28,307	0	110	14	0	28,183
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.