Benefits Timeliness and Quality Review System

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form ETA 9057 Section V Benefits Time Lapse and Quality	Form and Instruction	Modified	Available
Form ETA 9056 Section V Benefits Time Lapse and Quality	Form and Instruction	Modified	Available
Form ETA 9054 Section V Benefits Time Lapse and Quality	Form and Instruction	Modified	Available
Form ETA 9052 Section V Benefits Time Lapse and Quality	Form and Instruction	Modified	Available
Form ETA 9051 Section V Benefits Time Lapse and Quality	Form and Instruction	Modified	Available
Form ETA 9050 Section V Benefits Time Lapse and Quality	Form and Instruction	Modified	Available
Form ETA 9055 Section V Benefits Time Lapse and Quality	Form and Instruction	Modified	Available
1205-0359 Supporting Statement Part A_FINAL 3.17.17.docx	Supporting Statement A	Uploaded 2017-03-17	Available
1205-0359 Supporting Statement Part B_FINAL 2.16.17.docx	Supporting Statement B	Uploaded 2017-02-21	Available
Signed Part B Clearance_OCEO Approval.pdf	Supplementary Document	Uploaded 2017-02-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13147	Benefits Timeliness and Quality (BTQ) Review System	Form and Instruction	Modified	Section V Benefits Time Lapse and Quality
13147	Benefits Timeliness and Quality (BTQ) Review System	Form and Instruction	Modified	Section V Benefits Time Lapse and Quality
13147	Benefits Timeliness and Quality (BTQ) Review System	Form and Instruction	Modified	Section V Benefits Time Lapse and Quality
13147	Benefits Timeliness and Quality (BTQ) Review System	Form and Instruction	Modified	Section V Benefits Time Lapse and Quality
13147	Benefits Timeliness and Quality (BTQ) Review System	Form and Instruction	Modified	Section V Benefits Time Lapse and Quality
13147	Benefits Timeliness and Quality (BTQ) Review System	Form and Instruction	Modified	Section V Benefits Time Lapse and Quality
13147	Benefits Timeliness and Quality (BTQ) Review System	Form and Instruction	Modified	Section V Benefits Time Lapse and Quality

ICR Details

OMB Control No: 1205-0359	ICR Reference No: 201702-1205-003
Status: Historical Active	Previous ICR Reference No: 201307-1205-002
Agency/Subagency: DOL/ETA	Agency Tracking No: 012-05-01-05-09-2035-00
Title: Benefits Timeliness and Quality Review System
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/27/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/31/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2020	36 Months From Approved	06/30/2017
Responses	28,356	0	29,196
Time Burden (Hours)	37,812	0	38,692
Cost Burden (Dollars)	0	0	0

---

Abstract: These reports provide data necessary to monitor state performance in administration of Unemployment Insurance as mandated by the Secretary of Labor.

---

Authorizing Statute(s): US Code: 42 USC 503(a)(6) Name of Law: Social Security Act
   US Code: 26 USC 3303 and 3304 Name of Law: Internal Revenue Code of 1986
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 61254	09/06/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 16062	03/31/2017
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Benefits Timeliness and Quality (BTQ) Review System	ETA 9050, ETA 9056, ETA 9054, ETA 9055, ETA 9051, ETA 9052, ETA 9057	Section V Benefits Time Lapse and Quality ,   Section V Benefits Time Lapse and Quality ,   Section V Benefits Time Lapse and Quality ,   Section V Benefits Time Lapse and Quality ,   Section V Benefits Time Lapse and Quality ,   Section V Benefits Time Lapse and Quality ,   Section V Benefits Time Lapse and Quality

---

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	28,356	29,196	0	0	-840	0
Annual Time Burden (Hours)	37,812	38,692	0	0	-880	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: Samples sizes for nonmonetary and appeals quarterly reviews are determined by total workload for the prior calendar year. When states workloads change, the number of cases they are required to review is subject to change. Therefore adjustments were made that reclassified some states from large to small, resulting in a decrease in burden.

---

Annual Cost to Federal Government: $662,998

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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

---

Common Form ICR:  No

---

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: 03/31/2017

---