View Information Collection Request (ICR) Package

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: 1205-0172	ICR Reference No: 202001-1205-003
Status: Historical Active	Previous ICR Reference No: 201611-1205-004
Agency/Subagency: DOL/ETA	Agency Tracking No: UPI 012-05-01-05-01-2035-00
Title: Benefit Appeals Report
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/19/2020
	Date Received in OIRA: 05/18/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2023	36 Months From Approved	06/30/2020
Responses	1,272	0	1,272
Time Burden (Hours)	1,272	0	1,272
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved
Annual Number of Responses	1,272	1,272
Annual Time Burden (Hours)	1,272	1,272
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This ICR seeks no approval for discretionary actions affecting respondent burden. However, adjustments were made to reflect the expiration of Federal Emergency Unemployment Compensation Program, which occurred on January 1, 2014. DOL has refined the burden estimate entries for this collection, to make the relationship between reginfo.gov database information more consistent with the burden reported to respondents. As shown in item 12, each month States submit a separate ETA 5130 for each of the two programs and each form takes 1 hour to complete. The form provides that burden estimate. The database, however, reflected a single monthly response taking two hours.

Annual Cost to Federal Government: $34,158

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. 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? No

Agency Contact: Maya Kelley 202 693-2805 kelley.maya@dol.gov

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