ENROLLMENT AND DEPARTURE REPORT

ICR 198404-1205-001

OMB: 1205-0032

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
120650 Migrated
ICR Details
1205-0032 198404-1205-001
Historical Active 198209-1205-007
DOL/ETA
ENROLLMENT AND DEPARTURE REPORT
Revision of a currently approved collection   No
Regular
Approved without change 05/10/1984
Retrieve Notice of Action (NOA) 04/09/1984
  Inventory as of this Action Requested Previously Approved
05/31/1987 05/31/1987 05/31/1984
61,000 0 30,000
5,063 0 2,500
0 0 0

THIS FORM IS USED TO ASCERTAIN WHETHER THE APPLICANT ACCEPTS THE CENTE ASSIGNMENT INDICATED ON THE TRAVEL AUTHORIZATION (ETA 628) RECEIVED FROM THE ETA REGIONAL OFFICE. THE RO NOTIFIES THE SCREENER AND IF THE YOUTH ACCEPTS THE ASSIGNMENT, THE FORM IS COMPLETED AND ACCOMPANIES THE YOUTH TO THE CENTER. IT ALSO IS A VEHICLE FOR COLLECTING DATA ON ASSIGNMENTS REFUSED BY YOUTHS.

None
None


No

1
IC Title Form No. Form Name
ENROLLMENT AND DEPARTURE REPORT ETA 657

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 61,000 30,000 0 0 31,000 0
Annual Time Burden (Hours) 5,063 2,500 0 0 2,563 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
04/09/1984


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