Information Collection

MIS Data Entry-Grantees

IC 201975 under ICR 201905-1205-003 · OMB 1205-0507.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA Form No. 9166 MIS Data Entry-Grantees	Form
Attach L_H-1B Data Elements for Performance and Evaluation.xlsx	Other-Data Elements
Attach B_H-1B RTW Performance Handbook.docx	Instruction
ETA Form No. 9166 H-1B Standardized Quarterly Performance Progress Report Attach G_H-1B RTW QPR Form_Final.xlsx	Form
Baseline Informati Baseline Information Form Attach M_Baseline Information Form.doc	Form
JIAC Quarterly Rep H-1B JOBS AND INNOVATION ACCELERATOR CHALLENGE GRANTS Qu Attach F_H-1B TST JIAC QPR Form.xlsx	Form
Attach G_H-1B RTW QPR Form_Final.xlsx Standard QPR Form	IC Document
Attach B_H-1B RTW Performance Handbook.docx H-1B Performance Reporting Handbook	IC Document

IC Title:

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA Form No. 9166	H-1B Standardized Quarterly Performance Progress Report Form	Attach G_H-1B RTW QPR Form_Final.xlsx	Yes	Yes	Fillable Fileable
Instruction			Attach B_H-1B RTW Performance Handbook.docx	Yes	Yes	Fillable Fileable
Form	Baseline Information Form	Baseline Information Form	Attach M_Baseline Information Form.doc	Yes	Yes	Fillable Fileable
Form	JIAC Quarterly Report Form	H-1B JOBS AND INNOVATION ACCELERATOR CHALLENGE GRANTS Quarterly Report Form	Attach F_H-1B TST JIAC QPR Form.xlsx	Yes	Yes	Fillable Fileable
Other-Data Elements			Attach L_H-1B Data Elements for Performance and Evaluation.xlsx	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: DOL-ETA -15

FR Citation: 75 FR 6884

Number of Respondents: 24

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	7,371	-17,629	25,000
Annual IC Time Burden (Hours)	17,174	-41,076	58,250
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Standard QPR Form	Attach G_H-1B RTW QPR Form_Final.xlsx	05/13/2019
H-1B Performance Reporting Handbook	Attach B_H-1B RTW Performance Handbook.docx	05/13/2019

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