Information Collection Request

SCSEP Performance Measurement System

ICR 201103-1205-009 · OMB 1205-0040 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form ETA-9120 SCSEP Participant Data Form (State) Form Modified Available
Form ETA 9123 SCSEP Exit Form (National) Form Modified Repair queued
Form ETA 9123 SCSEP Exit Form (State) Form Modified Available
Form ETA 9122 SCSEP Unsubsidized Employment Form (National) Form Modified Available
Form ETA 9122 SCSEP Unsubsidized Employment Form (State) Form Modified Available
Form ETA-9121 SCSEP Community Service Assignment Form (National) Form Modified Repair queued
Form ETA-9121 SCSEP Community Service Assignment Form (State) Form Modified Available
Form ETA 9120 SCSEP Participant Data Form (National) Form Modified Available
Form ETA-8705 SCSEP Equitable Distribution Report Form Modified Available
Form ETA 9124A SCSEP Participant Customer Satisfaction Survey Form and Instruction Modified Repair queued
Form ETA 9124B SCSEP Employer and Host Agency Customer Satisfaction Surveys Form and Instruction Modified Available
1205-0040 SupportPartA 3 24 2011.doc Supporting Statement A Uploaded 2011-03-25 Available
1205-0040 SupportPartB_9_30_10.pdf Supporting Statement B Uploaded 2011-03-16 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
43785 SCSEP Participant Data Form (State) Form Modified
185407 SCSEP Four-Year State Strategy Instruction Modified
181013 SCSEP Exit Form (National) Form Modified
181011 SCSEP Exit Form (State) Form Modified
181010 SCSEP Unsubsidized Employment Form (National) Form Modified
181009 SCSEP Unsubsidized Employment Form (State) Form Modified
181008 SCSEP Community Service Assignment Form (National) Form Modified
181007 SCSEP Community Service Assignment Form (State) Form Modified
180574 SCSEP Participant Data Form (National) Form Modified
180499 SCSEP Equitable Distribution Report Form Modified
180161 SCSEP Participant Customer Satisfaction Survey Form and Instruction Modified
180160 SCSEP Employer and Host Agency Customer Satisfaction Surveys Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2014 36 Months From Approved 03/31/2011
374,279 0 324,446
51,179 0 45,740
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 374,279 324,446 0 0 49,833 0
Annual Time Burden (Hours) 51,179 45,740 0 0 5,439 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
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