Information Collection

Intake Forms and Return Visits, Staff

IC 198226 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 B.pdf	Other-intake

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-intake			WIA Evaluation - Appendix B.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: 270

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	810	810
Annual IC Time Burden (Hours)	16,250	16,250
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.