Information Collection

TAA, ATAA Petition, 9042A and 9042A-1, filled out by state/local workforce staff

IC 187430 under ICR 200810-1205-007 · OMB 1205-0342.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0342 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA-9042a TAA/ATAA Petition TAA, ATAA Petition, 9042A and 9042A-1, filled out by state/local workforce staff	Form and Instruction
Form ETA 9042a-1 ETA 9042a-1 petition, Spanish language version TAA, ATAA Petition, 9042A and 9042A-1, filled out by state/local workforce staff	Form and Instruction
Form ETA-9042a, online TAA/ATAA petition, online version TAA, ATAA Petition, 9042A and 9042A-1, filled out by state/local workforce staff	Form and Instruction
ETA-9042a TAA/ATAA Petition ETA-9042a Revised TAA and ATAA petition 12-12-08.docm	Form and Instruction
ETA 9042a-1 ETA 9042a-1 petition, Spanish language version ETA 9042a-1 Revised TAA and ATAA petition_Spanish 12-12-08.docm	Form and Instruction
ETA-9042a, online TAA/ATAA petition, online version ETA-9042a Revised TAA and ATAA petition 12.10.08 (online version).doc	Form and Instruction

IC Title:

TAA, ATAA Petition, 9042A and 9042A-1, filled out by state/local workforce staff

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 90

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA-9042a	Yes	Yes	Fillable Printable
Form and Instruction	ETA 9042a-1	Yes	Yes	Fillable Printable
Form and Instruction	ETA-9042a, online version	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 440

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	440	440
Annual IC Time Burden (Hours)	183	183
Annual IC Cost Burden (Dollars)	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.

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