Information Collection

Individual Characteristics

IC 184551 under ICR 201005-1205-011 · OMB 1205-0371.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0371 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA-9061 Individual Characteristics	Form and Instruction
ETA-9061 WOTC Individual Characteristics ETA Form 9061 (Aug 2009 w-Disclosure Language 6-8-10).doc	Form and Instruction

IC Title:

Individual Characteristics

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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
Form and Instruction	ETA-9061	WOTC Individual Characteristics	ETA Form 9061 (Aug 2009 w-Disclosure Language 6-8-10).doc		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 990,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	990,000	990,000
Annual IC Time Burden (Hours)	326,700	326,700
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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