Job Corps Application Data

Forms and Documents

Document Name	Status
Form ETA-655 Job Corps Application Data Form and Instruction	Modified
Job Corps Privacy Act Statement final approved by OMB 2010.doc Supplementary Document	2010-11-15
NTR(20100830).doc Supplementary Document	2010-08-30
OJC SUPPORTING STATEMENT 1205-0025 Oct 7 2010.doc Supporting Statement A	2010-11-10
Student Rights to Privacy and Disclosure of Information.pdf Supplementary Document	2010-05-14
Privacy Act Statement Given to Each Applicant.pdf Supplementary Document	2010-05-14

IC Document Collections

IC ID	Document Title	Status
12941	Job Corps Application Data Form and Instruction	Modified

ICR Details

OMB Control No: 1205-0025	ICR Reference No: 201004-1205-001
Status: Historical Active	Previous ICR Reference No: 200701-1205-003
Agency/Subagency: DOL/ETA	Agency Tracking No:
Title: Job Corps Application Data
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/19/2010
	Date Received in OIRA: 08/30/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2013	36 Months From Approved
Responses	92,122	0	0
Time Burden (Hours)	18,424	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Forms ETA 652, 655 and 682 are used to obtain information for screening and enrollment purposes to determine eligibility for the Job Corp program in accordance with the requirements of the Workforce Investment Act. They concern questions of economic criteria and past behavior problems as well as questions needed to certify an applicant's arrangements for care of a dependent child(ren) while the applicant is in Job Corps.

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Authorizing Statute(s): PL: Pub.L. 105 - 220 C Name of Law: Workforce Investment Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 4107	01/26/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 50781	08/17/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Job Corps Application Data	ETA-655, ETA 682, ETA 652	Statement from Court or Other Agency ,   Child Care Certification ,   Job Corps Data Sheet

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ICR Summary of Burden

	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	92,122	0	0	0	0	92,122
Annual Time Burden (Hours)	18,424	0	0	0	2,266	16,158
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The marginal increase in time burden from 16,158 hours to the 18,424 hours currently requested is due to the fact that ETA assigned one minute to the time it takes to complete Form ETA-652 (rather than the half minute, or thirty seconds, approved previously in ROCIS). Thus the total for the three forms, as an annualized estimate, is now 12 minutes instead of 11 minutes and 30 seconds.

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Annual Cost to Federal Government: $885,577

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 08/30/2010

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