Information Collection

Petition, ETA-9042 and 9042a, filled out by company or union officials/representatives

IC 187426 under ICR 201603-1205-003 · OMB 1205-0342.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0342 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 9042 Petition, ETA-9042 and 9042a, filled out by company or union officials/representatives	Form and Instruction
ETA 9042 Petition ETA-9042 English Petition (2015-08-31).docx	Form and Instruction
ETA 9042a Petition in Spanish ETA-9042A Spanish Petition.doc	Form and Instruction
ETA-9042 English Petition mark-up for 2015.doc 9042	IC Document
ETA-9042A Spanish Petition mark-up for 2015.doc 9042A	IC Document
ETA-9042 reversion changes to online petition screens.doc ETA 9042	IC Document

IC Title:

Petition, ETA-9042 and 9042a, filled out by company or union officials/representatives

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 90

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 9042	Petition	ETA-9042 English Petition (2015-08-31).docx		Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9042a	Petition in Spanish	ETA-9042A Spanish Petition.doc		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 736

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	736	-1,049	1,785
Annual IC Time Burden (Hours)	243	-501	744
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
9042	ETA-9042 English Petition mark-up for 2015.doc	07/27/2015
9042A	ETA-9042A Spanish Petition mark-up for 2015.doc	07/27/2015
ETA 9042	ETA-9042 reversion changes to online petition screens.doc	03/18/2016

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