View Information Collection (IC)

View Information Collection (IC)

IC Title:	Representative Fee Request	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 10.700-703 20 CFR 702.132

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CA-143 and CA-155	Attorney Fee Request	ca-143 for 1240-0049.doc		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: DOL-ESA Notice 15 and DOL/GOVT-1	FR Citation: 58 FR 49599

Number of Respondents: 12,363	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	12,363	0	0	3,959	0	8,404
Annual IC Time Burden (Hours)	6,182	0	0	763	0	5,419
Annual IC Cost Burden (Dollars)	15,696	0	0	2,890	0	12,806

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.