Information Collection

Reporting Requirements for Tribal Government Grantees, Adult and Youth Programs

IC 13267 under ICR 201001-1205-001 · OMB 1205-0422.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0422 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA-9084 Reporting Requirements for Tribal Government Grantees, Adult and Youth Programs	Form
1205-0422 SPIR instructions final.doc	Instruction
ETA 9085 SUpplemental Youth Services Report 9085 SYSP report form W Highlights.pdf	Form
ETA-9084 Comprehensive Services Quarterly Performance Report 9084 CSP report form 1205-0422.pdf	Form
1205-0422 Bear Tracks system privacy statement.doc Disclosure Statement in BearTracks System	IC Document

IC Title:

Reporting Requirements for Tribal Government Grantees, Adult and Youth Programs

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 652 et al

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-9084	Comprehensive Services Quarterly Performance Report	9084 CSP report form 1205-0422.pdf	Yes	Yes	Fillable Fileable
Instruction			1205-0422 SPIR instructions final.doc	Yes	Yes	Fillable Fileable
Form	ETA 9085	SUpplemental Youth Services Report	9085 SYSP report form W Highlights.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: 85

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	15,175	-1,899	17,074
Annual IC Time Burden (Hours)	58,173	-15,792	73,965
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Disclosure Statement in BearTracks System	1205-0422 Bear Tracks system privacy statement.doc	03/12/2010

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