Information Collection

Supplementary Budget Request Activities

IC 212051 under ICR 201406-1205-001 · OMB 1205-0517.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0517 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA-9165 Quarterly Reporting Form for Supplemental Activities Supplementary Budget Request Activities	Form and Instruction
Form ETA-9165 Quarterly Narrative Progress Report ETA Form-9165 Supplementary Budget Request Activities	Form
ETA-9165 Quarterly Reporting Form for Supplemental Activities 1205-0NEW_ETA-9165_Reporting_Instructions_ETA-9165_CLEAN.tr20150107.doc	Form and Instruction
ETA-9165 Quarterly Narrative Progress Report ETA Form-9165 Quarterly Narrative Progress Report_ETA 9165 gg.docx	Form

IC Title:

Supplementary Budget Request Activities

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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-9165				Yes	Yes	Fillable Printable
Form	ETA-9165				Yes	Yes	Fillable Printable

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	212	212
Annual IC Time Burden (Hours)	1,237	1,237
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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