Information Collection

ETA Reporting Requirements for Programs reporting on ETA 9130

IC 44659 under ICR 201605-1205-007 · OMB 1205-0461.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0461 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 9130 (Basic) ETA Reporting Requirements for Programs reporting on ETA 9130	Form and Instruction
ETA 9130 (Basic) Financial Status Report 160523 - ETA-9130 - Basic.pdf	Form and Instruction
ETA 9130 A Employment Services - Unemployment Insurance Financial R 160523 - ETA-9130 (A) - Statewide Youth.pdf	Form and Instruction
ETA 9130 B Local Youth 160523 - ETA-9130 (B) - Local Youth.pdf	Form and Instruction
ETA 9130 C Statewide Adult 160523 - ETA-9130 (C) - Statewide Adult.pdf	Form and Instruction
ETA 9130 D Local Adult 160523 - ETA-9130 (D) - Local Adult.pdf	Form and Instruction
ETA 9130 E Statewide Dislocated Worker 160523 - ETA-9130 (E) - Statewide Dislocated Worker.pdf	Form and Instruction
ETA 9130 F Local Dislocated Worker 160523 - ETA-9130 (F) - Local Dislocated Worker.pdf	Form and Instruction
ETA 9130 G National Dislocated Worker Grants 160523 - ETA-9130 (G) - National Dislocated Worker Grants.pdf	Form and Instruction
ETA 9130 H Statewide Rapid Response 160523 - ETA-9130 (H) - Statewide Rapid Response.pdf	Form and Instruction
ETA 9130 I Employment Services & Unemployment Insurance 160523 - ETA-9130 (I) - Employment Services & Unemployment Insurance.pdf	Form and Instruction
ETA 9130 J National Farmworker Jobs Program 160523 - ETA-9130 (J) - National Farmworker Jobs Program.pdf	Form and Instruction
ETA 9130 K Senior Community Service Employment Program 160523 - ETA-9130 (K) - Senior Community Service Employment Program.pdf	Form and Instruction
ETA 9130 L Indian and Native American Program 160523 - ETA-9130 (L) - Indian and Native American Program.pdf	Form and Instruction
ETA 9130 M Trade Adjustment Assistance Program 160523 - ETA-9130 (M) - Trade Adjustment Assistance Program.pdf	Form and Instruction
160523 - ETA-9130 - Basic Instructions.doc Track Changes - ETA 9130 (Basic)	IC Document
160523 - ETA-9130 (A) - Statewide Youth Instructions.doc Track Changes - ETA 9130 A	IC Document
160523 - ETA-9130 (B) - Local Youth Instructions.doc Track Changes - ETA 9130 B	IC Document
160523 - ETA-9130 (C) - Statewide Adult Instructions.doc Track Changes - ETA 9130 C	IC Document
160523 - ETA-9130 (D) - Local Adult Instructions.doc Track Changes - ETA 9130 D	IC Document
160523 - ETA-9130 (E) - Statewide Dislocated Worker Instructions.doc Track Changes - ETA 9130 E	IC Document
160523 - ETA-9130 (F) - Local Dislocated Worker Instructions.doc Track Changes - ETA 9130 F	IC Document
160523 - ETA-9130 (G) - Natl Disl. Worker Grants Instructions.doc Track Changes - ETA 9130 G	IC Document
160523 - ETA-9130 (H) - Statewide Rapid Response Instructions.doc Track Changes - ETA 9130 H	IC Document
160523 - ETA-9130 (I) - Empl. Serv. and Unempl. Ins. Instructions.doc Track Changes - ETA 9130 I	IC Document
160523 - ETA-9130 (J) - Natl Farmworker Jobs Prog. Instructions.doc Track Changes - ETA 9130 J	IC Document
160523 - ETA-9130 (K) - Sen. Comm. Serv. Empl. Prog. Instructions.doc Track Changes - ETA 9130 K	IC Document
160523 - ETA-9130 (L) - Indian and Native Am. Prog. Instructions.doc Track Changes - ETA 9130 L	IC Document
160523 - ETA-9130 (M) - Trade Adj. Assistance Prog. Instructions.doc Track Changes - ETA 9130 M	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

ETA Reporting Requirements for Programs reporting on ETA 9130

Agency IC Tracking Number:

0461-0408

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 2 CFR 2900 20 CFR 683.150, 200, 300 2 CFR 200 20 CFR 683.730, 740, 750 20 CFR 681.430

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
Form and Instruction	ETA 9130 (Basic)	Financial Status Report	160523 - ETA-9130 - Basic.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 A	Employment Services - Unemployment Insurance Financial Report	160523 - ETA-9130 (A) - Statewide Youth.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 B	Local Youth	160523 - ETA-9130 (B) - Local Youth.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 C	Statewide Adult	160523 - ETA-9130 (C) - Statewide Adult.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 D	Local Adult	160523 - ETA-9130 (D) - Local Adult.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 E	Statewide Dislocated Worker	160523 - ETA-9130 (E) - Statewide Dislocated Worker.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 F	Local Dislocated Worker	160523 - ETA-9130 (F) - Local Dislocated Worker.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 G	National Dislocated Worker Grants	160523 - ETA-9130 (G) - National Dislocated Worker Grants.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 H	Statewide Rapid Response	160523 - ETA-9130 (H) - Statewide Rapid Response.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 I	Employment Services & Unemployment Insurance	160523 - ETA-9130 (I) - Employment Services & Unemployment Insurance.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 J	National Farmworker Jobs Program	160523 - ETA-9130 (J) - National Farmworker Jobs Program.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 K	Senior Community Service Employment Program	160523 - ETA-9130 (K) - Senior Community Service Employment Program.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 L	Indian and Native American Program	160523 - ETA-9130 (L) - Indian and Native American Program.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9130 M	Trade Adjustment Assistance Program	160523 - ETA-9130 (M) - Trade Adjustment Assistance Program.pdf	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20,000

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	Previously Approved
Annual Number of Responses for this IC	20,000	0	20,000
Annual IC Time Burden (Hours)	15,001	1	15,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Track Changes - ETA 9130 (Basic)	160523 - ETA-9130 - Basic Instructions.doc	05/23/2016
Track Changes - ETA 9130 A	160523 - ETA-9130 (A) - Statewide Youth Instructions.doc	05/23/2016
Track Changes - ETA 9130 B	160523 - ETA-9130 (B) - Local Youth Instructions.doc	05/23/2016
Track Changes - ETA 9130 C	160523 - ETA-9130 (C) - Statewide Adult Instructions.doc	05/23/2016
Track Changes - ETA 9130 D	160523 - ETA-9130 (D) - Local Adult Instructions.doc	05/23/2016
Track Changes - ETA 9130 E	160523 - ETA-9130 (E) - Statewide Dislocated Worker Instructions.doc	05/23/2016
Track Changes - ETA 9130 F	160523 - ETA-9130 (F) - Local Dislocated Worker Instructions.doc	05/23/2016
Track Changes - ETA 9130 G	160523 - ETA-9130 (G) - Natl Disl. Worker Grants Instructions.doc	05/23/2016
Track Changes - ETA 9130 H	160523 - ETA-9130 (H) - Statewide Rapid Response Instructions.doc	05/23/2016
Track Changes - ETA 9130 I	160523 - ETA-9130 (I) - Empl. Serv. and Unempl. Ins. Instructions.doc	05/23/2016
Track Changes - ETA 9130 J	160523 - ETA-9130 (J) - Natl Farmworker Jobs Prog. Instructions.doc	05/23/2016
Track Changes - ETA 9130 K	160523 - ETA-9130 (K) - Sen. Comm. Serv. Empl. Prog. Instructions.doc	05/23/2016
Track Changes - ETA 9130 L	160523 - ETA-9130 (L) - Indian and Native Am. Prog. Instructions.doc	05/23/2016
Track Changes - ETA 9130 M	160523 - ETA-9130 (M) - Trade Adj. Assistance Prog. Instructions.doc	05/23/2016

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