Information Collection

Employer/Institution Re-Verification

IC 204982 under ICR 201608-1205-005 · OMB 1205-0426.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0426 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix D_FINAL 4.29.16.pdf	Other-survey questinonaire

IC Title:

Employer/Institution Re-Verification

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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
Other-survey questinonaire			Appendix D_FINAL 4.29.16.pdf		Yes	Yes	Paper Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: DOL/GOVT-2 (Job Corps Student Records)

FR Citation: 67 FR 16815

Number of Respondents: 5,000

Number of Respondents for Small Entity: 4,944

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Previously Approved
Annual Number of Responses for this IC	5,000	0	5,000
Annual IC Time Burden (Hours)	1,000	150	850
Annual IC Cost Burden (Dollars)	0	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.