Information Collection

Work Site Description (prospective applicants)

IC 200351 under ICR 201806-1205-002 · OMB 1205-0464.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0464 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 9143 Work Site Description (prospective applicants)	Form and Instruction
ETA 9143 Work Site Description and Annual Housing Census Forms ETA-9143 Work Site Description and AHC forms_FINAL 7.20.18.pdf	Form and Instruction

IC Title:

Work Site Description (prospective applicants)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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
Form and Instruction	ETA 9143	Work Site Description and Annual Housing Census Forms	ETA-9143 Work Site Description and AHC forms_FINAL 7.20.18.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: 230

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	230	-195	425
Annual IC Time Burden (Hours)	115	-98	213
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.