Application for Job Placement and Training Services

ICR 200403-1076-002

OMB: 1076-0062

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
11457 Migrated
ICR Details
1076-0062 200403-1076-002
Historical Active 200301-1076-001
DOI/BIA
Application for Job Placement and Training Services
Extension without change of a currently approved collection   No
Regular
Approved with change 08/11/2004
Retrieve Notice of Action (NOA) 03/23/2004
  Inventory as of this Action Requested Previously Approved
08/31/2007 08/31/2007 08/31/2004
4,900 0 4,900
2,450 0 2,450
0 0 0

This form requests information on the age, marital status, employment, education and income of applicant for training or job placement services. This information is used to determine applicant's eligibility and amount of financial assistance needed.

None
None


No

1
IC Title Form No. Form Name
Application for Job Placement and Training Services 8205

  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 4,900 4,900 0 0 0 0
Annual Time Burden (Hours) 2,450 2,450 0 0 0 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.
03/23/2004


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