ETA 9162 Report for Random Audit Activity

Unemployment Insurance Random Audit of EUC 2008 Claimants

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0495 can be found here:

Documents and Forms

Document Name Document Type
Form ETA 9162 ETA 9162 Report for Random Audit Activity Form and Instruction
ETA 9162 Random Audit Revised reporting instructions for 1205-XXXX ETA9162 Random Audit.doc Form and Instruction
Sampling Procedures for EUC Audits.doc Sampling Procedures 5 8 2012 IC Document
WS Sample Selection v2.xlsx sampling selection IC Document

Information Collection (IC) Details

IC Title:	ETA 9162 Report for Random Audit Activity	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA 9162	Random Audit	Revised reporting instructions for 1205-XXXX ETA9162 Random Audit.doc		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	212	212
Annual IC Time Burden (Hours)	9,116	9,116
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Sampling Procedures 5 8 2012	Sampling Procedures for EUC Audits.doc	05/09/2012
sampling selection	WS Sample Selection v2.xlsx	05/09/2012

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