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Program Monitoring Report and Job Service Complaint Form
Program Monitoring Report and Job Service Complaint Form
OMB: 1205-0039
IC ID: 12963
OMB.report
DOL/ETA
OMB 1205-0039
ICR 200509-1205-003
IC 12963
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0039 can be found here:
2024-02-13 - Revision of a currently approved collection
2023-06-30 - Extension without change of a currently 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:
Program Monitoring Report and Job Service Complaint Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
ETA-5148
Yes
Yes
Form
ETA-8429
Yes
Yes
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,833
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
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
2,348
0
0
0
0
2,348
Annual IC Time Burden (Hours)
1,566
0
0
0
0
1,566
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.