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Weekly Claims and Extended Benefits Data and Weekly Initial and Continued Weeks Claimed
Weekly Claims and Extended Benefits Data and Weekly Initial and Continued Weeks Claimed
OMB: 1205-0028
IC ID: 43784
OMB.report
DOL/ETA
OMB 1205-0028
ICR 201909-1205-002
IC 43784
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0028 can be found here:
2022-08-30 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form ETA 538
Weekly Claims and Extended Benefits Data and Weekly Initial and Continued Weeks Claimed
Form and Instruction
ETA 538 Section 1 Claimant Activity
Section1_ClaimantActivity_ETA 538.doc
Form and Instruction
ETA 539 Claimant Activity
SectionI_ClaimantActivity_ETA 539.doc
Form and Instruction
-SectionI_ClaimantActivity_ETA 538 2019 (track changes).docx
ETA 538 Tracked Changes
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Weekly Claims and Extended Benefits Data and Weekly Initial and Continued Weeks Claimed
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:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
ETA 538
Section 1 Claimant Activity
Section1_ClaimantActivity_ETA 538.doc
Yes
Yes
Fillable Fileable
Form and Instruction
ETA 539
Claimant Activity
SectionI_ClaimantActivity_ETA 539.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Unemployment Compensation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
53
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
98 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
5,512
0
0
0
0
5,512
Annual IC Time Burden (Hours)
3,675
0
0
0
0
3,675
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
ETA 538 Tracked Changes
-SectionI_ClaimantActivity_ETA 538 2019 (track changes).docx
09/18/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.