Information Collection

Program Performance Report (States)

IC 221251 under ICR 201802-1205-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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 (States)	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 1.18.18.xlsx	Form and Instruction

IC Title:

Program Performance Report (States)

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 641

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 1.18.18.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: 57

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	912	-3,104	4,016
Annual IC Time Burden (Hours)	3,648	-12,416	16,064
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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