Information Collection

TAA Program Reserve Funding Request Form

IC 46190 under ICR 201907-1205-008 · OMB 1205-0275.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0275 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA-9117 TAA Program Reserve Funding Request Form	Form and Instruction
ETA-9117 Trade Adjustment Assistance (TAA) Program Funding Reques ETA-9117 2019-7-25 FINAL.docx	Form and Instruction
ETA-9117 Redline.docx ETA-9117 Redline - Changes	IC Document

IC Title:

TAA Program Reserve Funding Request Form

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 618.920

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-9117	Trade Adjustment Assistance (TAA) Program Funding Request Form	ETA-9117 2019-7-25 FINAL.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 25

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	Previously Approved
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
ETA-9117 Redline - Changes	ETA-9117 Redline.docx	07/19/2019

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