Migrant and Seasonal Farmworker Monitoring Report and One-Stop Career Center Complaint/Referral Record

Forms and Documents

Document Name	Status
Form ETA 8429 Job Service Complaint, Individual/Household Burden Form	New
Form ETA 5148 Program Monitoring/Reporting/Recordkeeping Form and Instruction	Modified
Form ETA 8429 Job Service Complaint Form	Modified
1205-0039 Supporting Statement final Oct 16 2015.docx Supporting Statement A	2015-10-22

IC Document Collections

IC ID	Document Title	Status
218422	Job Service Complaint, Individual/Household Burden Form	New
186595	Program Monitoring/Reporting/Recordkeeping Form and Instruction	Modified
12963	Job Service Complaint Form	Modified

ICR Details

OMB Control No: 1205-0039	ICR Reference No: 201509-1205-001
Status: Historical Active	Previous ICR Reference No: 201112-1205-007
Agency/Subagency: DOL/ETA	Agency Tracking No: EBSS: 012-05-01-02-02-2025-00.
Title: Migrant and Seasonal Farmworker Monitoring Report and One-Stop Career Center Complaint/Referral Record
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: 12/09/2015
	Date Received in OIRA: 10/22/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2018	36 Months From Approved	12/31/2015
Responses	7,322	0	3,250
Time Burden (Hours)	8,992	0	7,378
Cost Burden (Dollars)	0	0	0

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Abstract: These forms are necessary as part of federal regulations at 20 CFR Parts 651, 653 and 658. ETA 5148 collects data which are primarily used to monitor and measure the extent and effectiveness of State Workforce Agencies service delivery to migrant and seasonal farm workers (MSFWs). ETA 8429, the One-Stop Career Center Compliance Referral Record, is used to collect and document complaints filed by MSFWs and non-MSFWs regarding service delivery.

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Authorizing Statute(s): US Code: 29 USC 49i Name of Law: Wagner Peyser Act as Amended
  

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:
	79 FR 65425	11/04/2014
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: 3

IC Title	Form No.	Form Name
Program Monitoring/Reporting/Recordkeeping	ETA 5148	LEARS Handbook
Job Service Complaint	ETA 8429	Complaint Form
Job Service Complaint, Individual/Household Burden	ETA 8429	Complaint Form

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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	7,322	3,250	0	0	4,072	0
Annual Time Burden (Hours)	8,992	7,378	0	0	1,614	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 burden estimates for ETA 8429 are slightly higher to reflect the most current data on complaint submission. In addition, an estimate of individual/household burden for completing the complaint form was added as a separate IC.

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Annual Cost to Federal Government: $9,434

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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