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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.