Information Collection

Prisoner Reentry Initiative (PRI) Quarterly Reporting System

IC 13319 under ICR 201506-1205-005 · OMB 1205-0455.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0455 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Privacy Act Notification screen from PRI Web.doc	Other-privacy act notification
ETA 9140 Quarterly Report Form Quarterly Performance Report PRI Grant ETA-9140.pdf	Form
Annotated Sample Form ETA-9140.pdf ETA 9140	IC Document

IC Title:

Prisoner Reentry Initiative (PRI) Quarterly Reporting System

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Other-privacy act notification			Privacy Act Notification screen from PRI Web.doc		Yes	Yes	Fillable Fileable
Form	ETA 9140	Quarterly Report Form	Quarterly Performance Report PRI Grant ETA-9140.pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: DOL/ETA-15

FR Citation: 68 FR 16898

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	160	-144	304
Annual IC Time Burden (Hours)	5,120	256	4,864
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
ETA 9140	Annotated Sample Form ETA-9140.pdf	09/09/2015

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