Information Collection

Prospective Applicants' Work Site Description A&B

IC 200351 under ICR 201409-1205-004 · OMB 1205-0464.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.