Standard Job Corps reporting forms

Standard Job Corps Contractor Information Gathering

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0219 can be found here:

Documents and Forms

Document Name Document Type
Form ETA 661 Standard Job Corps reporting forms Form
ETA 661 Student Separation ETA 661 Student Separation 6.28.16.pdf Form
ETA 640 Student Profile ETA 640 Student Profile 6.28.16.pdf Form
ETA 2110 Center Financial Report eta 2110 Center Financial report.pdf Form
ETA 2181 Center Operations Budget eta 2181 Center Operations Budget.pdf Form
ETA 6-131A and 6-1 Disciplinary Discharge ETA 6-131A and 6-131B Disciplinary Discharge 6.28.16.pdf Form
ETA 6-131C Right to Appeal ETA 6-131C Right to Appeal 6.28.16.pdf Form
ETA 328 Property Inventory ETA 328 Property Inventory 6.28.16.pdf Form
6-37 INSPECTION OF RESIDENTIAL AND EDUCATIONAL FACILITIES Inspection of Residential and Educational Facilities_OJC 6-37.pdf Form
6-39 INSPECTION OF WASTEWATER TREATMENT FACILITIES Inspection of WasteWater Treatment Facilities_OJC 6-39.pdf Form
6-38 INSPECTION OF WATER SUPPLY FACILITIES Inspection of Water and Supply Facilities_OJC 6-38.pdf Form and Instruction
privacy2-3.gif Privacy Statement IC Document

Information Collection (IC) Details

IC Title:	Standard Job Corps reporting forms	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 686

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA 661	Student Separation	ETA 661 Student Separation 6.28.16.pdf	Yes	Yes	Fillable Fileable
Form	ETA 640	Student Profile	ETA 640 Student Profile 6.28.16.pdf	Yes	Yes	Fillable Fileable
Form	ETA 2110	Center Financial Report	eta 2110 Center Financial report.pdf	Yes	Yes	Fillable Fileable
Form	ETA 2181	Center Operations Budget	eta 2181 Center Operations Budget.pdf	Yes	Yes	Fillable Fileable
Form	ETA 6-131A and 6-131B	Disciplinary Discharge	ETA 6-131A and 6-131B Disciplinary Discharge 6.28.16.pdf	Yes	Yes	Fillable Fileable
Form	ETA 6-131C	Right to Appeal	ETA 6-131C Right to Appeal 6.28.16.pdf	Yes	Yes	Fillable Fileable
Form	ETA 328	Property Inventory	ETA 328 Property Inventory 6.28.16.pdf	Yes	Yes	Fillable Fileable
Form	6-37	INSPECTION OF RESIDENTIAL AND EDUCATIONAL FACILITIES	Inspection of Residential and Educational Facilities_OJC 6-37.pdf	Yes	Yes	Fillable Fileable
Form	6-39	INSPECTION OF WASTEWATER TREATMENT FACILITIES	Inspection of WasteWater Treatment Facilities_OJC 6-39.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	6-38	INSPECTION OF WATER SUPPLY FACILITIES	Inspection of Water and Supply Facilities_OJC 6-38.pdf	Yes	Yes	Fillable Fileable

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: 2,543	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	197,459	12,831	184,628
Annual IC Time Burden (Hours)	54,442	15,832	38,610
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Privacy Statement	privacy2-3.gif	05/06/2016

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