Information Collection

YouthBuild Grantee Quarterly Reports and Housing Site Report

IC 180934 under ICR 201107-1205-002 · OMB 1205-0464.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0464 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 9143, Part C YouthBuild Grantee Quarterly Reports and Housing Site Report	Form
ETA 9143, Part C Annual Housing Census Work Site with ANNUAL HOUSING CENSUS, Part C.xls	Form
ETA 9143 Parts A a Work Site Description Parts A and B Work Site Description final Parts A and B.xls	Form
ETA 9136 MIS System, Quarterly Reports Revised screenshot of YB PRA statement and exp date.docx	Form and Instruction

IC Title:

YouthBuild Grantee Quarterly Reports and Housing Site Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 672

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
Form	ETA 9143, Part C	Annual Housing Census	Work Site with ANNUAL HOUSING CENSUS, Part C.xls	Yes	Yes	Fillable Fileable Signable
Form	ETA 9143 Parts A and B	Work Site Description Parts A and B	Work Site Description final Parts A and B.xls	Yes	Yes	Fillable Fileable Signable
Form and Instruction	ETA 9136	MIS System, Quarterly Reports	Revised screenshot of YB PRA statement and exp date.docx	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 220

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,035	220	0	1,815
Annual IC Time Burden (Hours)	28,307	110	14	28,183
Annual IC Cost Burden (Dollars)	0	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.