TAA Program Reserve Funding Request Form

Trade Adjustment Assistance Program Reserve Funding Request

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0275 can be found here:

Documents and Forms

Document Name Document Type
Form ETA 9117 TAA Program Reserve Funding Request Form Form and Instruction
ETA 9117 Trade Adjustment Assistance (TAA) Program Reserve Fundin Form ETA 9117_FINAL 5.11.16.xls Form and Instruction

Information Collection (IC) Details

IC Title:	TAA Program Reserve Funding Request Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 618.920

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA 9117	Trade Adjustment Assistance (TAA) Program Reserve Funding Request Form	Form ETA 9117_FINAL 5.11.16.xls		Yes	Yes	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.