Information Collection

Job Corps Application Data

IC 12941 under ICR 200701-1205-003 · OMB 1205-0025.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0025 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA-652, 655, 682 Job Corps Application Data	Form
ETA-652, 655, 682 Job Corps Data Sheet, Statement from Court or other Agen Data Input Screens for OMS Forms - 2006.doc	Form
ETA-652 Primary Applicant Form ETA-652.pdf	Form
ETA-655 Statement from Court ETA-655.pdf	Form
ETA-682 Child Care Certification ETA-682.pdf	Form

IC Title:

Job Corps Application Data

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA-652, 655, 682	Job Corps Data Sheet, Statement from Court or other Agency, Child Care Certification	Data Input Screens for OMS Forms - 2006.doc	Yes	Yes	Fillable Fileable
Form	ETA-652	Primary Applicant Form	ETA-652.pdf	Yes	Yes	Fillable Fileable
Form	ETA-655	Statement from Court	ETA-655.pdf	Yes	Yes	Fillable Fileable
Form	ETA-682	Child Care Certification	ETA-682.pdf	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 87,943

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	92,122	-15,597	107,719
Annual IC Time Burden (Hours)	16,158	-2,736	18,894
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.