Prospective Applicants' Work Site Description A&B

YouthBuild Reporting System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0464 can be found here:

Documents and Forms

Document Name Document Type
Form ETA 9143 Part A Prospective Applicants' Work Site Description A&B Form
ETA 9143 Part A Part A Work Site Form with Annual Housing Census Part-A_Work Site Form with Annual Housing Census_5-11-2015.xlsx Form
ETA 9143 Part B Part B Work Site Form with Annual Housing Census Part-B_Work Site Form with Annual Housing Census_5-11-2015.xlsx Form

Information Collection (IC) Details

IC Title:	Prospective Applicants' Work Site Description A&B	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 672

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA 9143 Part A	Part A Work Site Form with Annual Housing Census	Part-A_Work Site Form with Annual Housing Census_5-11-2015.xlsx		Yes	Yes	Fillable Fileable Signable
Form	ETA 9143 Part B	Part B Work Site Form with Annual Housing Census	Part-B_Work Site Form with Annual Housing Census_5-11-2015.xlsx		Yes	Yes	Fillable Fileable Signable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 425	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	425	0	425
Annual IC Time Burden (Hours)	213	142	71
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.