Information Collection

Workfoce Investment Act: National Emergency Grants for Trade Health Insurance Assistance-Application and Reporting Procedures

IC 13301 under ICR 200211-1205-004 · OMB 1205-0439.

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Documents and Forms

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Document Name	Document Type

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IC Title:

Workfoce Investment Act: National Emergency Grants for Trade Health Insurance Assistance-Application and Reporting Procedures

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	ETA-9106	Yes	Yes
Form	ETA-9103	Yes	Yes
Form	ETA-9104	Yes	Yes
Form	ETA-9105	Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	440	440
Annual IC Time Burden (Hours)	333	333
Annual IC Cost Burden (Dollars)	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.