Information Collection

Weekly Claims and Extended Benefits Data and Weekly Initial and Continued Weeks Claimed

IC 43784 under ICR 201012-1205-004 · OMB 1205-0028.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0028 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 539 Weekly Claims and Extended Benefits Data and Weekly Initial and Continued Weeks Claimed	Form and Instruction
ETA-538 Advanced Weekly Initial and Continued Claims Report Section1_ClaimantActivity_ETA 538.doc	Form and Instruction
ETA-539 Weekly Claims and Extended Benefits Trigger Data SectionI_ClaimantActivity_ETA 539.doc	Form and Instruction
ETA 539 Section I Claimant Activity UIPL 04-10 Change 7 - Attachment II - Revised ETA 539 instructions.doc	Form and Instruction

IC Title:

Weekly Claims and Extended Benefits Data and Weekly Initial and Continued Weeks Claimed

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA-538	Advanced Weekly Initial and Continued Claims Report	Section1_ClaimantActivity_ETA 538.doc	Yes	Yes	Fillable Fileable
Form and Instruction	ETA-539	Weekly Claims and Extended Benefits Trigger Data	SectionI_ClaimantActivity_ETA 539.doc	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 539	Section I Claimant Activity	UIPL 04-10 Change 7 - Attachment II - Revised ETA 539 instructions.doc	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 53

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 98 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	5,512	5,512
Annual IC Time Burden (Hours)	3,675	3,675
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.