Information Collection

RExO participant survey at 36 months

IC 197890 under ICR 201105-1205-003 · OMB 1205-0498.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0498 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix_B_survey, early bird 5 23 2012.docx	Other-survey
Appendix_B_survey,regular 5 23 2012.docx	Other-survey
Appendix_D_Agree_to_participate_.doc Agree to Participate	IC Document
RExO_ADVANCE_LETTER 5 23 2012.doc Advance Letter	IC Document
RExO_ADVANCE_LETTER, without early bird incentive, 6.1.2012.doc advance letter without early bird incentive	IC Document

IC Title:

RExO participant survey at 36 months

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-survey			Appendix_B_survey, early bird 5 23 2012.docx		Yes	Yes	Fillable Fileable
Other-survey			Appendix_B_survey,regular 5 23 2012.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: DOL/ETA-15, published April 8, 2002

FR Citation: 67 FR 16898

Number of Respondents: 3,262

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,262	3,262
Annual IC Time Burden (Hours)	1,631	1,631
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Agree to Participate	Appendix_D_Agree_to_participate_.doc	01/20/2012
Advance Letter	RExO_ADVANCE_LETTER 5 23 2012.doc	05/23/2012
advance letter without early bird incentive	RExO_ADVANCE_LETTER, without early bird incentive, 6.1.2012.doc	06/01/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.