Information Collection

Participant Intake, Return and Site Visits

IC 198217 under ICR 201101-1205-001 · OMB 1205-0482.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
WIA Evaluation - Appendix A.pdf	Other-consent to participate
WIA Evaluation - Appendix B.pdf	Other-intake form
Appendix C.pdf	Other-protocols

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-consent to participate	WIA Evaluation - Appendix A.pdf	Yes	Yes	Fillable Printable
Other-intake form	WIA Evaluation - Appendix B.pdf	Yes	Yes	Fillable Printable
Other-protocols	Appendix C.pdf	Yes	Yes	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: DOL/ETAÂ15ÂDOL/ETA Evaluation, Research Pilot or Demonstration ContractorsÂ Project Files

FR Citation: 67 FR 16816

Number of Respondents: 65,224

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	65,224	65,224
Annual IC Time Burden (Hours)	14,307	14,307
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.