Information Collection

Program Performance Report

IC 221251 under ICR 201710-1205-004 · OMB 1205-0521.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0521 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA-9173 Program Performance Report Template and Specifications Program Performance Report	Form and Instruction
WIPS Grantee Quick Start Guide v0.2.pdf	Instruction
WIPS Quick Ref Guide v0.6.pdf	Instruction
ETA-9173 Program Performance Report Template and Specifications ETA-9173_FINAL 12.7.17.xlsx	Form and Instruction
ETA-9173_(changes) 12.7.17.xlsx Program Performance Report Template and Specifications	IC Document

IC Title:

Program Performance Report

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 677

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA-9173	Program Performance Report Template and Specifications	ETA-9173_FINAL 12.7.17.xlsx	Yes	Yes	Fillable Fileable
Instruction			WIPS Grantee Quick Start Guide v0.2.pdf	Yes	Yes	Fillable Fileable
Instruction			WIPS Quick Ref Guide v0.6.pdf	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,004

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	4,016	528	3,488
Annual IC Time Burden (Hours)	16,064	2,112	13,952
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Program Performance Report Template and Specifications	ETA-9173_(changes) 12.7.17.xlsx	01/09/2018

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