Weekly Claims and Extended Benefits Data and Weekly Initial and Continued Weeks Claimed

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0028 can be found here:

Documents and Forms

Document Name Document Type
Form ETA 539 Weekly Claims and Extended Benefits Data and Weekly Initial and Continued Weeks Claimed Form and Instruction
ETA 538 Section 1 Claimant Activity Section1_ClaimantActivity_ETA 538.doc Form and Instruction
ETA 539 Claimant Activity SectionI_ClaimantActivity_ETA 539.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Weekly Claims and Extended Benefits Data and Weekly Initial and Continued Weeks Claimed	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA 539	Claimant Activity	SectionI_ClaimantActivity_ETA 539.doc		Yes	Yes	Fillable Fileable
Form and Instruction	ETA 538	Section 1 Claimant Activity	Section1_ClaimantActivity_ETA 538.doc		Yes	Yes	Fillable Fileable

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: 98 %

	Approved	Previously Approved
Annual Number of Responses for this IC	5,512	5,512
Annual IC Time Burden (Hours)	3,675	3,675
Annual IC Cost Burden (Dollars)	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.