ETA 9131 Employer Services Report

EMPLOYER SERVICES REPORT (ETA FORM 9131)

OMB No.

1205-0469

Expires

10/31/2011

A. GRANTEE IDENTIFYING INFORMATION

1. Grantee Name:

3. Workforce Programs

Wagner-Peyser Employment Service WIA Title I Programs Jobs for Veterans State Grants-DVOP/LVER Programs

2. Grantee Mailing Address:

4. Report Quarter End Date:

____________________________________________________________

mm/dd/yyyy

City ________________________________

State ______ Zip Code __________

5. Report Due Date:

mm/dd/yyyy

Performance Information

Previous Quarter (A)

Current Quarter (B)

Cumulative 4-Qtr Period (C)

B. CUSTOMER SUMMARY INFORMATION

B.1 EMPLOYER CUSTOMERS SERVED

1. Total Employer Establishments Served

1a. Fewer than 10 workers

1b. 10 - 99 workers

1c. 100 or more workers

B.2 STATE JOB BANK HOLDINGS

Total Number of Job Bank Listings

B.3 EMPLOYER CUSTOMERS SERVED AND JOB OPENINGS BY INDUSTRY SECTOR

Total Employers (A1)

Total Job Openings (A2)

Total Employers (B1)

Total Job Openings (B2)

Total Employers (C1)

Total Job Openings (C2)

1. Totals (All Industry Sectors)

2. Agriculture, Forestry, Fishing/Hunting

3. Mining

4. Utilities

5. Construction

6. Manufacturing

7. Wholesale Trade

8. Retail Trade

9. Transportation and Warehousing

10. Information

11. Finance and Insurance

12. Real Estate and Rental and Leasing

13. Professional, Scientific, and Technical Svcs.

14. Mgmt. of Companies and Enterprises

15. Admin. and Spt. Waste Mgmt and Remediation Svcs.

16. Educational Services

17. Health Care and Social Assistance

18. Arts, Entertainment, and Recreation

19. Accommodation and Food Services

20. Other Services (except public administration)

21. Public Administration

22. Federal Contractors

Performance Information

Previous Quarter (A)

Current Quarter (B)

Cumulative 4-Qtr Period (C)

C. CUSTOMER SERVICES AND ACTIVITIES

1. Business Information and Support Services

2. Workforce Recruitment Assistance

3. Strategic Planning/Economic Development Activities

4. Untapped Labor Pools Activities

5. Training Services

5a. Incumbent Worker Training Services

6. Rapid Response/Business Downsizing Assistance

6a. Planning Layoff Response

D. PERFORMANCE RESULTS (OPTIONAL)

1. State Determined Measure #1

Numerator

Numerator

Denominator

Denominator

2. State Determined Measure #2

3. State Determined Measure #3

E. REPORT CERTIFICATION/ADDITIONAL COMMENTS

1. Report Comments/Narrative:

2. Name of Grantee Certifying Official/Title:

3. Telephone Number:

4. Email Address:

OMB Burden Statement: These reporting instructions have been approved under the Paperwork Reduction Act of 1995. Persons are not required to respond to this collection of information unless it displays a currently valid OMB number. Obligation to respond is required to obtain or retain benefits (Workforce Investment Act [Section 185(a)(2)], Wagner-Peyser Act [29 USC 49i] and Trade Adjustment Assistance [20 CFR 617.61]). The 13 hour public reporting burden for this collection of information, which is to assist with planning and program management and to meet Congressional and statutory requirements, includes time to review instructions, search existing data sources, gather and maintain the data needed, and complete and review the collection of information. Send comments regarding this burden estimate, or any other aspect of this collection, including suggestions for reducing burden, to the U.S. Department of Labor, Employment and Training Administration, Office of Policy Development and Research, Room N-5641, 200 Constitution Avenue, NW, Washington, DC 20210.