Information Collection

Workforce Investment Act: National Emergency Grant (NEG) Assistance-Application and Reporting Procedures

IC 13302 under ICR 201507-1205-003 · OMB 1205-0439.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0439 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 9104 Workforce Investment Act: National Emergency Grant (NEG) Assistance-Application and Reporting Procedures	Form
ETA 9103-1 Planning Form (Regular) Planning Form 9103-1 final 5.4.16.doc	Form
ETA 9103-2a Planning Form (Disaster-Temporary Jobs) Planning Form 9103-2a final 5.4.16.doc	Form
ETA 9103-2b Planning Form (Disaster Workforce Development Services) Planning Form 9103-2b final 5.4.16.doc	Form
ETA 9103-3 Planning Form (Dual Enrollment) Planning Form 9103-3 final 5.4.16.doc	Form
ETA 9104 Quarterly Performance Report Quarterly Performance Report Form 9104 final 5.4.16.doc	Form
ETA 9105 Employer Data Form Employer Data Form 9105 final 5.4.16.doc	Form
ETA 9106 Project Synopsis Form Project Synopsis Form 9106 final 5.4.16.doc	Form
ETA 9107 Project Operator Data Form Project Operator Data Form 9107 final 5.4.16.doc	Form
Planning Form 9103(1) 2-24-15.doc Planning Form 9103-1 (track changes)	IC Document
Planning Form 9103(2a) 2-24-15.doc Planning Form 9103-2a (track changes)	IC Document
Planning Form 9103(2b) 2-24-15.doc Planning Form 9103-2b (track changes)	IC Document
Planning Form 9103(3) 2-24-15.doc Planning Form 9103-3 (track changes)	IC Document
Quarterly Performance Report Form 9104 2-24-15.doc Quarterly Performance Report Form 9104 (track changes)	IC Document
Employer Data Form 9105 2-12-15.doc Employer Data Form 9105 (track changes)	IC Document
Project Synopsis Form 9106 2-24-15.doc Project Synopsis Form 9106 (track changes)	IC Document
Project Operator Data Form 9107 2-12-15.doc Project Operator Data Form 9107 (track changes)	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Workforce Investment Act: National Emergency Grant (NEG) Assistance-Application and Reporting Procedures

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 687.150

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA 9104	Quarterly Performance Report	Quarterly Performance Report Form 9104 final 5.4.16.doc	Yes	Yes	Fillable Fileable
Form	ETA 9105	Employer Data Form	Employer Data Form 9105 final 5.4.16.doc	Yes	Yes	Fillable Fileable
Form	ETA 9106	Project Synopsis Form	Project Synopsis Form 9106 final 5.4.16.doc	Yes	Yes	Fillable Fileable
Form	ETA 9107	Project Operator Data Form	Project Operator Data Form 9107 final 5.4.16.doc	Yes	Yes	Fillable Fileable
Form	ETA 9103-1	Planning Form (Regular)	Planning Form 9103-1 final 5.4.16.doc	Yes	Yes	Fillable Fileable
Form	ETA 9103-2a	Planning Form (Disaster-Temporary Jobs)	Planning Form 9103-2a final 5.4.16.doc	Yes	Yes	Fillable Fileable
Form	ETA 9103-2b	Planning Form (Disaster Workforce Development Services)	Planning Form 9103-2b final 5.4.16.doc	Yes	Yes	Fillable Fileable
Form	ETA 9103-3	Planning Form (Dual Enrollment)	Planning Form 9103-3 final 5.4.16.doc	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 159

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	Previously Approved
Annual Number of Responses for this IC	1,587	102	1,485
Annual IC Time Burden (Hours)	1,086	80	1,006
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Planning Form 9103-1 (track changes)	Planning Form 9103(1) 2-24-15.doc	05/04/2016
Planning Form 9103-2a (track changes)	Planning Form 9103(2a) 2-24-15.doc	05/04/2016
Planning Form 9103-2b (track changes)	Planning Form 9103(2b) 2-24-15.doc	05/04/2016
Planning Form 9103-3 (track changes)	Planning Form 9103(3) 2-24-15.doc	05/04/2016
Quarterly Performance Report Form 9104 (track changes)	Quarterly Performance Report Form 9104 2-24-15.doc	05/04/2016
Employer Data Form 9105 (track changes)	Employer Data Form 9105 2-12-15.doc	05/04/2016
Project Synopsis Form 9106 (track changes)	Project Synopsis Form 9106 2-24-15.doc	05/04/2016
Project Operator Data Form 9107 (track changes)	Project Operator Data Form 9107 2-12-15.doc	05/04/2016

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