Information Collection

Unemployment Insurance (UI) State Quality Service Plan (SQSP)

IC 12980 under ICR 201103-1205-004 · OMB 1205-0132.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0132 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Table of Contents.doc	Other-Table of Contents
Chapter I.doc	Instruction
Chapter II.doc	Instruction
Appendix IV.doc	Instruction
ETA-8623A State Plan Worksheet, UI-1 Appendix I.doc	Form and Instruction
UI-III State Plan Worksheet Appendix II.doc	Form and Instruction
Appendix III, 1205 Performance Measures Appendix III.pdf	Form and Instruction

IC Title:

Unemployment Insurance (UI) State Quality Service Plan (SQSP)

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
Other-Table of Contents			Table of Contents.doc	Yes	Yes	Fillable Fileable
Instruction			Chapter I.doc	Yes	Yes	Fillable Printable
Instruction			Chapter II.doc	Yes	Yes	Fillable Fileable
Form and Instruction	ETA-8623A	State Plan Worksheet, UI-1	Appendix I.doc	Yes	Yes	Fillable Fileable
Form and Instruction	UI-III	State Plan Worksheet	Appendix II.doc	Yes	Yes	Fillable Fileable
Form and Instruction	Appendix III, 1205-0132	Performance Measures	Appendix III.pdf	Yes	Yes	Fillable Fileable
Instruction			Appendix IV.doc	Yes	Yes	Fillable Fileable

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: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	583	0	583
Annual IC Time Burden (Hours)	1,963	153	1,810
Annual IC Cost Burden (Dollars)	0	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.