Certification Regarding Rights to Unemployment Benefits

Certification Regarding Rights to Unemployment Benefits

OMB: 3220-0079

IC ID: 33878

Information Collection (IC) Details

View Information Collection (IC)

Certification Regarding Rights to Unemployment Benefits
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 320.5

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form UI-45 (proposed) Claimant's Statement - Voluntary Leaving of Work Form UI-45 (proposed).pdf No   Paper Only
Form UI-45 (08-04) Claimant's Statement - Voluntary Leaving of Work Form UI-45 (08-04).pdf No   Paper Only

Income Security Unemployment Compensation

RRB-6, Unemployment Insurance Records  40 FR 36269

1,000 0
   
Individuals or Households
 
   0 %

  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 1,950 0 -950 0 0 2,900
Annual IC Time Burden (Hours) 408 0 -79 0 0 487
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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