Information Collection

Employment Assistance & Recruiting Network (EARN) Employer and Provider Enrollment Form, and Surveys

IC 14741 under ICR 200604-1230-001 · OMB 1230-0003.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Employment Assistance & Recruiting Network (EARN) Employer and Provider Enrollment Form, and Surveys

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	EARN-4	Yes	Yes
Form	EARN-1	Yes	Yes
Form	EARN-2	Yes	Yes
Form	EARN-3	Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,669

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,788	-12,312	14,100
Annual IC Time Burden (Hours)	437	-4,218	4,655
Annual IC Cost Burden (Dollars)	0	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.