Information Collection

UI Lower Authority Appeal Information Technology Assessment

IC 208086 under ICR 201005-1205-002 · OMB 1205-0436.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0436 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
UI LAA Questionnaire August 2013.docx	Other-questionnaire
UI LAA Abbreviated OMB Supporting Statement August 7 2013.docx Supporting Statement	IC Document
Email Template to State Workforce Agencies August 7 2013.docx E Mail Letter to State Workforce Agencies	IC Document

IC Title:

UI Lower Authority Appeal Information Technology Assessment

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-questionnaire			UI LAA Questionnaire August 2013.docx		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 44

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	44	44
Annual IC Time Burden (Hours)	26	26
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement	UI LAA Abbreviated OMB Supporting Statement August 7 2013.docx	08/07/2013
E Mail Letter to State Workforce Agencies	Email Template to State Workforce Agencies August 7 2013.docx	08/07/2013

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