Information Collection

Program Status Summary

IC 221736 under ICR 201602-1205-003 · OMB 1205-0425.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 9095 Program Status Summary	Form and Instruction
ETA 9095 NFJP Program Status Summary Report FINAL_NFJP PSS Form 9095 2.26.16.docx www.doleta.gov/MSFW/pdf/Program-Status-Report-Form-9095.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA 9095	NFJP Program Status Summary Report	FINAL_NFJP PSS Form 9095 2.26.16.docx	http://www.doleta.gov/MSFW/pdf/Program-Status-Report-Form-9095.pdf	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 52

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
Annual Number of Responses for this IC	208	208
Annual IC Time Burden (Hours)	3,536	3,536
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.