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ETA-9042a and 9042A-1 Petition, individuals (three or more workers)
Petition Requirements and Investigative Data Collection: Trade Act of 1974, as amended
OMB: 1205-0342
IC ID: 13133
OMB.report
DOL/ETA
OMB 1205-0342
ICR 201209-1205-002
IC 13133
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0342 can be found here:
2022-08-05 - Extension without change of a currently approved collection
2021-07-01 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form ETA 9042
ETA-9042a and 9042A-1 Petition, individuals (three or more workers)
Form and Instruction
ETA 9042 Petition for Trade Adjustment Assistance
RevisedPetition - English.doc
Form and Instruction
ETA 9042A Petition for Trade Adjustment Assistance (in Spanish)
RevisedPetition - Spanish (Updated 08 13 12).doc
Form and Instruction
ETA 9042a-1 Petition for Trade Adjustment Assistance
online petition changes with screen shots gpg 8-10-2012.doc
Form and Instruction
Revised_Petition_Forms_to_File_for_Trade_Adjustment_Assistance(20111129).doc
TEGL
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
ETA-9042a and 9042A-1 Petition, individuals (three or more workers)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
29 CFR 90
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
ETA 9042
Petition for Trade Adjustment Assistance
RevisedPetition - English.doc
Yes
Yes
Fillable Fileable
Form and Instruction
ETA 9042A
Petition for Trade Adjustment Assistance (in Spanish)
RevisedPetition - Spanish (Updated 08 13 12).doc
Yes
Yes
Fillable Fileable
Form and Instruction
ETA 9042a-1
Petition for Trade Adjustment Assistance
online petition changes with screen shots gpg 8-10-2012.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
844
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
80 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
844
0
0
0
0
844
Annual IC Time Burden (Hours)
352
0
0
0
0
352
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
TEGL
Revised_Petition_Forms_to_File_for_Trade_Adjustment_Assistance(20111129).doc
11/29/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.