Job Corps Application Data

Forms and Documents

Document Name	Status
Form ETA 655 Job Corps Application Data Form and Instruction	Modified
1205-0025__supporting_statement_final_2013(2013-11-01).doc Supporting Statement A	2013-11-01
Job Corps Privacy Act Statement final approved by OMB 2010.doc Supplementary Document	2010-11-15
NTR(20100830).doc Supplementary Document	2010-08-30
Student Rights to Privacy and Disclosure of Information.pdf Supplementary Document	2010-05-14
Privacy Act Statement Given to Each Applicant.pdf Supplementary Document	2010-05-14

IC Document Collections

IC ID	Document Title	Status
12941	Job Corps Application Data Form and Instruction	Modified

ICR Details

OMB Control No: 1205-0025	ICR Reference No: 201306-1205-004
Status: Historical Active	Previous ICR Reference No: 201004-1205-001
Agency/Subagency: DOL/ETA	Agency Tracking No:
Title: Job Corps Application Data
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: 01/16/2014
	Date Received in OIRA: 11/08/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2017	36 Months From Approved	01/31/2014
Responses	179,723	0	92,122
Time Burden (Hours)	16,201	0	18,424
Cost Burden (Dollars)	0	0	0

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Abstract: Forms ETA 652, 655 and 682 are used to obtain information for screening and enrollment purposes to determine eligibility for the Job Corp program in accordance with the requirements of the Workforce Investment Act. They concern questions of economic criteria and past behavior problems as well as questions needed to certify an applicant's arrangements for care of a dependent child(ren) while the applicant is in Job Corps.

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Authorizing Statute(s): PL: Pub.L. 105 - 220 C Name of Law: Workforce Investment Act
  

Citations for New Statutory Requirements: None

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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
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 36599	06/18/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 67198	11/08/2013
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Job Corps Application Data	ETA 652, ETA 682, ETA 655	Statement from Court or Other Agency ,   Job Corps Data Sheet ,   Child Care Certification

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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	179,723	92,122	0	0	87,601	0
Annual Time Burden (Hours)	16,201	18,424	0	0	-2,223	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: There were no program changes; however, there has been a reduction in the number of applicants. The Department has also reconsidered its approach in counting the number of responses provided by each respondent and concluded that, while all forms may be filed at the same time, each form should be considered a separate response. These adjustments to the number of responses (from 92,122 to 179,723) do not affect burden time or other costs, except to the extent that there are fewer respondents. Also, the previous submission inadvertently included the estimated opportunity costs to participants for filling out forms as a Federal cost.

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Annual Cost to Federal Government: $704,889

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: 11/08/2013

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