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Indian and Native American Welfare-to-Work Program Report Forms and Instructions
Indian and Native American Welfare-to-Work Program Report Forms and Instructions
OMB: 1205-0386
IC ID: 13193
OMB.report
DOL/ETA
OMB 1205-0386
ICR 199712-1205-003
IC 13193
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0386 can be found here:
2004-09-30 - No material or nonsubstantive change to a currently approved collection
2003-10-03 - Reinstatement with change of a previously approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Indian and Native American Welfare-to-Work Program Report Forms and Instructions
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:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
ETA-9069-1
Yes
Yes
Form
ETA-9069
Yes
Yes
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
130
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
10 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,040
0
1,040
0
0
0
Annual IC Time Burden (Hours)
9,360
0
9,360
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.