Information Collection

Application and Claim for Unemployment Benefits and Employment Service

IC 33826 under ICR 200308-3220-002 · OMB 3220-0022.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0022 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Application and Claim for Unemployment Benefits and Employment Service	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.	Available Electronically?	Can Be Submitted Electronically?
Form	UI-1	Yes	Yes
Form	UI-3	Yes	Yes
Form	UI-1(INTERNET)	Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 2 %

	Approved	Previously Approved
Annual Number of Responses for this IC	78,700	78,700
Annual IC Time Burden (Hours)	8,617	8,617
Annual IC Cost Burden (Dollars)	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.