Information Collection

Employer Services Activity Report

IC 120587 under ICR 198009-1205-011 · OMB 1205-0024.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0024 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

EMPLOYER SERVICES ACTIVITY REPORT

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	ETA 520	No	No
Form	(FORMERLY	No	No
Form	MA 5-20)	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 52

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	624	0	624
Annual IC Time Burden (Hours)	1,036	-1,533	2,569
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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