Information Collection

Petition For Adjustment Assistance

IC 123891 under ICR 198107-1225-002 · OMB 1225-0001.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

PETITION FOR ADJUSTMENT ASSISTANCE

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	ILAB 20	No	No
Form	(REVISED),	No	No
Form	ILAB 20-1	No	No
Form	(SPANISH)	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,800

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,800	-713	-687	3,200
Annual IC Time Burden (Hours)	450	-1,400	-1,350	3,200
Annual IC Cost Burden (Dollars)	0	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.