View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	WOTC Self-Attestation Form (ETA-9154)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA 9154	Youth Self Attestation	Youth attachment I.doc		Yes	No	Printable Only
Form	ETA 9154, Spanish Version	Youth Self Attestation, Spanish Version	Youth Attachment II.doc		Yes	No	Printable Only

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: 53	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

	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	0	0	-106,000	0	0	106,000
Annual IC Time Burden (Hours)	0	0	-34,980	0	0	34,980
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
TEGL Change 3 Guidance	TEGL 5-19-10.doc with highlights.doc	05/20/2010

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.