Statement Regarding Benefit Claim for Days Worked

RUIA Investigations and Continuing Entitlement

OMB: 3220-0025

IC ID: 179869

Information Collection (IC) Details

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Statement Regarding Benefit Claim for Days Worked
 
No Modified
 
Voluntary
 
20 CFR 322.4

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction UI-48 (01-01) Statement Regarding Benefits Claimed for Days Worked Form UI-48 (01-01). pdf.pdf No   Paper Only

Litigation and Judicial Activities Resolution Facilitation

RRB 6; Unemployment Insurance Record File  75 FR 43716

14 0
   
Individuals or Households
 
   0 %

  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 14 0 0 9 0 5
Annual IC Time Burden (Hours) 3 0 0 2 0 1
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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