Information Collection

Job Service Complaint Form

IC 12963 under ICR 201112-1205-007 · OMB 1205-0039.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0039 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 8429 Job Service Complaint Form	Form and Instruction
ETA 8429 One Stop Career Center (OSCC) Complaint/Referral Record ETA 8429 Revised 07 15 2009[1].doc	Form and Instruction

IC Title:

Job Service Complaint Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 658

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
Form and Instruction	ETA 8429	One Stop Career Center (OSCC) Complaint/Referral Record	ETA 8429 Revised 07 15 2009[1].doc		Yes	Yes	Paper Only

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: 3,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,000	858	2,142
Annual IC Time Burden (Hours)	6,400	5,790	610
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.