Indian and Native American Welfare-to-Work Program Report Forms and Instructions

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
13194	Indian and Native American Welfare-to-Work Program Report Forms and Instructions Form	Migrated

ICR Details

OMB Control No: 1205-0386	ICR Reference No: 199807-1205-004
Status: Historical Active	Previous ICR Reference No: 199712-1205-003
Agency/Subagency: DOL/ETA	Agency Tracking No:
Title: Indian and Native American Welfare-to-Work Program Report Forms and Instructions
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: 09/29/1998
	Date Received in OIRA: 07/24/1998
Terms of Clearance: Approved as amended by an consistent with DOL's memo to OMB of 9/17/98 and 9/29/98. In addition, DOL agrees to the following terms of clearance: 1) Consistent with the 9/17 memo, ETA will submit to OMB any compilation of data from these quarterly reports. With those submissions ETA will include a brief update on the initiative to provide respondents with an option to complete and submit INA WtW reports through the Internet. b) Consistent with the 9/17 memo, ETA will work with the respondent community to see about the possibility of revising the reports to include *targeting* elements (e.g., data that would allow ETA to track what is happening to individuals that fall into different eligibility groups). In approaching the respondent community, DINAP should use as guidance the *targeting* elements as drafted and implemented in the quarterly reports of the mainline program.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2001	09/30/2001	09/30/1998
Responses	680	0	1,040
Time Burden (Hours)	6,120	0	9,360
Cost Burden (Dollars)	720,000	0	0

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Abstract: Extension of the approval of the report forms and instructions used by Indian and Native American Welfare-to-Work (INA WtW) grantees is being requested. These instructions and forms provide eligible tribal entities with requirements for preparing and submitting financial expenditure and activity reports to the Department so that they may be in compliance with the statutory reporting requirements of the INA WtW program.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Indian and Native American Welfare-to-Work Program Report Forms and Instructions	ETA-9069, ETA-9069-1

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ICR Summary of Burden

	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	680	1,040	0	0	-360	0
Annual Time Burden (Hours)	6,120	9,360	0	0	-3,240	0
Annual Cost Burden (Dollars)	720,000	0	0	0	720,000	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 07/24/1998

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