Information Collection

ETA 9162 Reporting for Random Audit Activity

IC 201532 under ICR 201208-1205-003 · OMB 1205-0495.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 9162 ETA 9162 Reporting for Random Audit Activity	Form and Instruction
ETA 9162 Reporting Instrucitons for Random Audit Reporting instructions for 1205-0495 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

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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 9162	Reporting Instrucitons for Random Audit	Reporting instructions for 1205-0495 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 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	212	0	212
Annual IC Time Burden (Hours)	636	-8,480	9,116
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.