Unemployment Insurance Benefits Operations Self-Assessment Report of Responses

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
TEN_8-14.pdf	Supplementary Document	Uploaded 2016-12-28	Available
1205-0NEW Supporting Statement_FINAL 1.12.17.doc	Supporting Statement A	Uploaded 2017-01-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
224974	Report of Responses to the UI Benefits Operations Self-Assessment Tool	Other-Review	New

ICR Details

OMB Control No: 1205-0529	ICR Reference No: 201612-1205-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOL/ETA	Agency Tracking No:
Title: Unemployment Insurance Benefits Operations Self-Assessment Report of Responses
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/17/2017
	Date Received in OIRA: 03/22/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2020	36 Months From Approved
Responses	53	0	0
Time Burden (Hours)	110,240	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The report of responses to the state self-assessment will support periodic reviews conducted by ETA’s Regional and National Office staff for purposes of oversight and monitoring as well as providing technical assistance. It enables ETA to assess the state’s activities and its administrative compliance with Federal law. The information gathered from the self-assessments will enable ETA Regional Office staff to work with the state to identify areas where performance improvements are needed. The results will be used to inform ETA’s technical assistance efforts nationally and with individual states, and will enable a more robust and effective collection and dissemination of state best practices.

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Authorizing Statute(s): US Code: 42 USC 503(a)(6) Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 42729	06/30/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 14750	03/22/2017
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Report of Responses to the UI Benefits Operations Self-Assessment Tool

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	53	0	0	53	0	0
Annual Time Burden (Hours)	110,240	0	0	110,240	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection.

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Annual Cost to Federal Government: $407,069

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/22/2017

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