Claims and Payment Activities

ICR 200911-1205-005

OMB: 1205-0010

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Unchanged
Justification for No Material/Nonsubstantive Change
2009-11-16
Supplementary Document
2009-11-16
Supplementary Document
2009-11-13
Supplementary Document
2009-11-13
IC Document Collections
IC ID
Document
Title
Status
12927 Unchanged
ICR Details
1205-0010 200911-1205-005
Historical Active 200907-1205-001
DOL/ETA
Claims and Payment Activities
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 11/17/2009
Retrieve Notice of Action (NOA) 11/17/2009
  Inventory as of this Action Requested Previously Approved
08/31/2012 08/31/2012 08/31/2012
636 0 636
1,272 0 1,272
0 0 0

The Form ETA-5159 report provides important program information on claims taking and benefit payment activities under state/federal unemployment insurance laws. These data are needed for budget preparation and control, program planning and evaluation, personnel assignment, actuarial and program research, and for accounting to Congress and the public. This collection is authorized under the Social Security Act, Title III, Section 303(a)(6).

US Code: 42 USC 5939(a) Name of Law: Social Security Act
  
None

Not associated with rulemaking

  74 FR 23886 05/21/2009
74 FR 36760 07/24/2009
No

1
IC Title Form No. Form Name
Claims and Payment Activities ETA 5159 Claims and Payment Activities

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 636 636 0 0 0 0
Annual Time Burden (Hours) 1,272 1,272 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The slight diminution of burden results from a correction of the agency's previous submission.

$0
No
No
Uncollected
Uncollected
No
Uncollected
Bonnie Naradzay 202-693-3675 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/17/2009


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