Reemployment and Eligibility Assessment Program

Forms and Documents

Document Name	Status
Form ETA 9128U EUC08 Reemployment Program Form and Instruction	Modified
Form ETA 9129 Reemployment and Eligibility Assessment Program Form and Instruction	Modified
Supporting_Statement_1205-0456 final 0ct 2012.docx Supporting Statement A	2012-10-24

IC Document Collections

IC ID	Document Title	Status
201540	EUC08 Reemployment Program Form and Instruction	Modified
13320	Reemployment and Eligibility Assessment Program Form and Instruction	Modified

ICR Details

OMB Control No: 1205-0456	ICR Reference No: 201208-1205-008
Status: Historical Active	Previous ICR Reference No: 201203-1205-007
Agency/Subagency: DOL/ETA	Agency Tracking No:
Title: Reemployment and Eligibility Assessment Program
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/08/2013
	Date Received in OIRA: 10/31/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2016	36 Months From Approved	01/31/2013
Responses	548	0	540
Time Burden (Hours)	274	0	270
Cost Burden (Dollars)	0	0	0

---

Abstract: DOL uses the information collected in ETA 9128 and ETA 9129 1) to evaluate state performance in terms of service delivery; and 2) to report on the REAs, including the number of scheduled in-person reemployment and eligibility assessments, the number of individuals who failed to appear for scheduled assessments, actions taken as a result of individuals not appearing for an assessment (e.g., benefits terminated), results of assessments (e.g., referred to reemployment services, found in compliance with program requirements), estimated savings resulting from cessation of benefits, and estimated savings as a result of accelerated reemployment. ETA 9128U, required by PL 112-96, is used 1) to evaluate state performance in terms of service delivery; and 2) to report on the REAs, including the number of scheduled in-person reemployment and eligibility assessments, the number of individuals who failed to appear for scheduled assessments, actions taken as a result of individuals not appearing for an assessment (e.g., benefits terminated), results of assessments (e.g., referred to reemployment services, found in compliance with program requirements), estimated savings resulting from cessation of benefits, and estimated savings as a result of accelerated reemployment.

---

Authorizing Statute(s): US Code: 42 USC 503(a)(6) Name of Law: Social Security Act
   PL: Pub.L. 112 - 96 2142 Name of Law: Middle Class Tax Relief and Job Creation Act of 2012.
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 48122	08/13/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 65716	10/30/2012
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
EUC08 Reemployment Program	ETA 9128U	Section IV Special Programs
Reemployment and Eligibility Assessment Program	ETA 9128, ETA 9129	Section IV Special Programs ,   Section IV Special Programs

---

ICR Summary 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	548	540	0	0	8	0
Annual Time Burden (Hours)	274	270	0	0	4	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The changes in burden reflect the fact that each state makes an individual decision in each year regarding their participation in the REA program. As a result, the number of reports we anticipate will change with the number of states participating. The change from 41 states to 42 states participating produces a very small increase in overall expected burden.

---

Annual Cost to Federal Government: $49,308

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

---

Common Form ICR:  No

---

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: 10/31/2012

---