Information Collection

Participant Reporting

IC 221308 under ICR 201709-1205-001 · OMB 1205-0526.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0526 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instructions - WIOA Wage Conversion Chart - 4.20.2016 FINAL.xlsx	Instruction
ETA-9170 WIOA PIRL ETA-9170_FINAL 12.4.17.xlsx	Form
ETA-9170_(changes) 12.4.17.xlsx Amended WIOA PIRL_ETA-9170	IC Document

IC Title:

Participant Reporting

Agency IC Tracking Number:

Is this a Common Form? Yes

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 677

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
Instruction			Instructions - WIOA Wage Conversion Chart - 4.20.2016 FINAL.xlsx		Yes	No	Printable Only
Form	ETA-9170	WIOA PIRL	ETA-9170_FINAL 12.4.17.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 19,102,174

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	19,102,174	2,865,326	16,236,848
Annual IC Time Burden (Hours)	4,775,544	716,332	4,059,212
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Amended WIOA PIRL_ETA-9170	ETA-9170_(changes) 12.4.17.xlsx	12/29/2017

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