Claims and Payment Activities

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form ETA 5159 Claims and Payment Activities	Form and Instruction	Modified	Available
supporting statement for 1205-0010 ETA 5159.doc	Supporting Statement A	Uploaded 2012-04-05	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
12927	Claims and Payment Activities	Form and Instruction	Modified

ICR Details

OMB Control No: 1205-0010	ICR Reference No: 201203-1205-012
Status: Historical Active	Previous ICR Reference No: 200911-1205-005
Agency/Subagency: DOL/ETA	Agency Tracking No:
Title: Claims and Payment Activities
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 04/13/2012
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/13/2012
	Date Received in OIRA: 04/06/2012
Terms of Clearance: The information collection requirements contained in this request are approved as submitted under the emergency processing procedures of the PRA. DOL will begin right away the process of soliciting public comment and obtaining approval under the normal PRA procedures.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2012	6 Months From Approved	08/31/2012
Responses	3,180	0	636
Time Burden (Hours)	34,980	0	1,272
Cost Burden (Dollars)	0	0	0

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Abstract: The Form ETA-5159 report provides important program information on claims taking and benefit payment activities under state/federal unemployment insurance laws. These data are needed for budget preparation and control, program planning and evaluation, personnel assignment, actuarial and program research, and for accounting to Congress and the public. This collection is authorized under the Social Security Act, Title III, Section 303(a)(6). A worksharing data cell is being added to the ETA-5159STC to comply with the newly enacted PL 112-96.

Emergency Justfication: Public Law 112-96, the Middle Class Tax Relief and Job Creation Act of 2012 (the Act), provides states with multiple opportunities to allow for expansions of the workshare/short time compensation (STC) program within the UI system. Currently, a number of states use STC as a layoff aversion program, and information is collected under OMB Control Number 1205-0010 on ETA 5159. A cell needs to be added to this form to implement the new worksharing program. Thus ETA seeks approval for this change to comply with section 2165(a)(3) of the Act. Emergency clearance is sought for OMB approval so that ETA can develop timely guidance and communicate programmatic expectations to the states that run the current programs, and to collect the necessary information from the States as required, insofar as the Act requires the data to be collected immediately.

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Authorizing Statute(s): US Code: 42 USC 503(a)(6) Name of Law: Social Security Act
   PL: Pub.L. 112 - 96 2165(a)(3) Name of Law: Middle Class Tax Relief and Job Creation Act of 2012
  

Citations for New Statutory Requirements: PL: Pub.L. 112 - 96 2165(a)(3) Name of Law: Middle Class Tax Relief and Job Creation Act of 2012

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Claims and Payment Activities	ETA 5159 STC, ETA 5159	Claims and Activities ,   Claims and Payment Activities (workshare)

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	3,180	636	636	0	1,908	0
Annual Time Burden (Hours)	34,980	1,272	29,892	0	3,816	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Reasons for the increase in burden hours from 1,272 to the current request for 34,980: 1) Prior supporting statements described the total burden on the 5159 report as two hours per state per monthly reporting. However, two hours is insufficient to submit any program-specific 5159 reports the state needed to provide. In the near future, the majority of states are submitting monthly 5159 reports for the regular, EB and EUC08 program. In addition, some states are still submitting TEUC-specific 5159s, and the expectation is that a number of states will adopt legislation or policies that will allow for an expansion of the STC program, resulting in requirements for STC reporting. 2) The new STC requirements will immediately be imposed on all states currently reporting STC data, as the law permanently changed the reporting requirements for the program, rather than tying them to the temporary provisions of the temporary grants to reimburse existing activities or allow states not currently engaged in STC activities to adopt them.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/06/2012

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