Unemployment Compensation for Federal Employees

Forms and Documents

Document Name	Status
Form 935 Unemployment Compensation for Federal Employees (Individuals) Form	New
Form 931 Unemployment Compensation for Federal Employees (States) Form	Modified
1205-0179 Supporting Statement_Final 10-21-15.doc Supporting Statement A	2015-10-21

IC Document Collections

IC ID	Document Title	Status
218054	Unemployment Compensation for Federal Employees (Individuals) Form	New
13026	Unemployment Compensation for Federal Employees (States) Form	Modified

ICR Details

OMB Control No: 1205-0179	ICR Reference No: 201508-1205-006
Status: Historical Active	Previous ICR Reference No: 201207-1205-001
Agency/Subagency: DOL/ETA	Agency Tracking No:
Title: Unemployment Compensation for Federal Employees
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/03/2016
	Date Received in OIRA: 10/22/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2019	36 Months From Approved	03/31/2016
Responses	296,123	0	273,330
Time Burden (Hours)	23,120	0	27,190
Cost Burden (Dollars)	0	0	0

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Abstract: The UCFE law (5 U.S.C. 8501, et seq.) requires state workforce agencies to administer the UCFE program in accordance with the same terms and provisions of the paying state's unemployment insurance law, which apply to unemployed claimants who worked in the private sector. Each state agency must be able to obtain certain information (wage, separation data) about each claimant filing claims for UCFE benefits to enable them to determine his/her eligibility for benefits. The Department of Labor (DOL) has prescribed forms to enable the state agencies to obtain this necessary information from the individual's Federal employing agency. Each of these forms is essential to the UCFE claims process and the frequency of use varies depending upon the circumstances involved. These are model forms which states may customize as needed to collect the necessary information required to operate the UCFE program.

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Authorizing Statute(s): US Code: 33 USC 3305(b) Name of Law: Federal Unemployment Tax Act
   US Code: 5 USC 8501 Name of Law: Unemployment Compensation for Federal Employees Act
   US Code: 42 USC 5939(a) Name of Law: Social Security Act
   US Code: 5 USC 8506 Name of Law: Unemployment Compensation for Federal Employees Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 20508	04/16/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 64020	10/22/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Unemployment Compensation for Federal Employees (Individuals)	935	ETA 935
Unemployment Compensation for Federal Employees (States)	931A, 933, 935, 934, 931	ETA 931 ,   ETA 931A ,   ETA 933 ,   ETA 934 ,   ETA 935

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	296,123	273,330	0	0	22,793	0
Annual Time Burden (Hours)	23,120	27,190	0	0	-4,070	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The increase in UCFE claims filed resulted in an upward adjustment in responses and burden hours. ETA-935 forms are used when a claimant files via an affidavit to verify the information that was provided by the claimant. In 2012, the country was in the midst of a recession, which would account for a higher than average number of claims. There was also an increase in UCFE due to the government shutdown in October 2013.

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Annual Cost to Federal Government: $85,321

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/22/2015

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