Information Collection

Comprehensive Services Program Report and Supplemental Youth Services Report (Forms ETA-9084 and ETA-9085) (Tribal Government Grantees)

IC 13267 under ICR 201511-1205-002 · OMB 1205-0422.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0422 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
INA-SPIR-Specifications- may 2013.doc	Instruction
ETA 9085 General Reporting Instructions for the Supplemental Yout ETA 9085 Sept 16 2013 final revised.doc	Form and Instruction
ETA 9084 General Reporting Instructions for the Comprehensive Ser ETA 9084 General Reporting Instructions September 5 20131final.doc	Form and Instruction
9085 Summer Youth Report Form 9085 SYSP Report Form September 5 13(1) final.xlsx	Form
ETA 9084 General Reporting Instructions September 5 20131.doc ETA 9084 Servies Program Report, added fields highlighted	IC Document
ETA 9085 General Instructions September 5 13.rtf ETA 9085 part D youth credential measures yellow highlighted	IC Document

IC Title:

Comprehensive Services Program Report and Supplemental Youth Services Report (Forms ETA-9084 and ETA-9085) (Tribal Government Grantees)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 652

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
Instruction			INA-SPIR-Specifications- may 2013.doc	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9085	General Reporting Instructions for the Supplemental Youth Services Program Report	ETA 9085 Sept 16 2013 final revised.doc	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9084	General Reporting Instructions for the Comprehensive Services Program Report and Standardized Participant Information Record Data	ETA 9084 General Reporting Instructions September 5 20131final.doc	Yes	Yes	Fillable Fileable
Form	9085	Summer Youth Report Form	9085 SYSP Report Form September 5 13(1) final.xlsx	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: DOL/ETA -15

FR Citation: 67 FR 16898

Number of Respondents: 81

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	Previously Approved
Annual Number of Responses for this IC	324	324
Annual IC Time Burden (Hours)	7,776	7,776
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
ETA 9084 Servies Program Report, added fields highlighted	ETA 9084 General Reporting Instructions September 5 20131.doc	09/17/2013
ETA 9085 part D youth credential measures yellow highlighted	ETA 9085 General Instructions September 5 13.rtf	09/17/2013

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