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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1205-0040
ICR Reference No:
201608-1205-001
Status:
Historical Inactive
Previous ICR Reference No:
201603-1205-006
Agency/Subagency:
DOL/ETA
Agency Tracking No:
Title:
Senior Community Service Employment Program Performance Measurement System
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Withdrawn and continue
Conclusion Date:
09/21/2016
Retrieve Notice of Action (NOA)
Date Received in OIRA:
08/09/2016
Terms of Clearance:
This change request is withdrawn per DOL's request. Prior terms remain in effect. Agency made updates to supporting statement to reflect changes to instruments as well as a notation to reflect the extension of pilot grants through December 2015. After these grants expire, the Department will submit a non-material change request to discontinue the use of these fields in the instruments associated with these grants.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
08/31/2018
08/31/2018
11/30/2018
Responses
232,520
0
232,520
Time Burden (Hours)
32,922
0
32,922
Cost Burden (Dollars)
0
0
0
Abstract:
This information collection contains program performance reports required for monitoring the Senior Community Service Employment Program (SCSEP). The current request is for an extension with the addition of a request for approval of an additional participant data indicator: participants' volunteer efforts.
Authorizing Statute(s):
PL:
Pub.L. 109 - 365 501-518
Name of Law: Older Americans Act Amendments of 2006
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
79 FR 65705
11/05/2014
30-day Notice:
Federal Register Citation:
Citation Date:
80 FR 16457
03/27/2015
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
12
IC Title
Form No.
Form Name
Quarterly Narrative Progress Report
SCSEP Community Service Assignment Form (National)
ETA 9121
Community Service Assignment Form
SCSEP Community Service Assignment Form (State)
ETA 9121
Community Service Assignment Form
SCSEP Employer and Host Agency Customer Satisfaction Surveys
ETA 9124C, ETA 9124B, ETA-9124-A
Host Agency Customer Satisfaction Survey
,
Employer Customer Satisfaction Survey
,
SCSEP Participant Survey Customer Satisfaction
SCSEP Equitable Distribution Report
ETA-8705
Equitable Distribution Report
SCSEP Exit Form (National)
ETA-9123
SPARQ Exit Form
SCSEP Exit Form (State)
ETA 9123
SPARQ Exit Form
SCSEP Four-Year State Strategy
SCSEP Participant Data Form (National)
ETA 9120
SPARQ Participant Form
SCSEP Participant Data Form (State)
Eta 9120
SPARQ Participant Form
SCSEP Unsubsidized Employment Form (National)
ETA 9122
Unsubsidized Employment Form
SCSEP Unsubsidized Employment Form (State)
ETA 9122
Unsubsidized Employment Form
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$65,713
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Walter Parker 202 693-2778 parker.walter@dol.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
08/09/2016
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