Document
U
ICR 201909-1205-004 · OMB 1205-0439 · Object 94663801.
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Document Metadata
| File Type | application/msword |
|---|---|
| File Title | U |
| Author | provost.jeanette |
| Last Modified By | Writer |
| File Modified | 2019-09-09 |
| File Created | 2026-09-13 |
| Conversion State | complete |
Extracted Text
U.S. Department of Labor OMB Control No. 1205-0439
Employment and Training Administration Expiration Date: XX/XX/XXXX
Planning Form (Regular) ETA 9103-1
National Dislocated Worker Grant Electronic Application System
All quarterly entries are CUMULATIVE over all previous quarters.
PERFORMANCE FACTOR
PROGRAM YEAR QUARTER
ADMIN
PROGRAM
QTR1
QTR2
QTR3
QTR4
QTR5
QTR6
QTR7
PLANNED PARTICIPANTS
Receiving Career Services
Receiving Training Services
Participating in Work-Based Learning
Receiving Supportive Services
Receiving Needs-Related Payments (NRP)
Completed NDWG Services
Employed at Completion of NDWG Services
Employed in Work-Based Learning at Completion of NDWG Services
Total Planned Participants
PLANNED GRANTEE EXPENDITURES
Admin (Excluding NRP Processing)
NRP Processing
Other
Total: Program Management and Oversight
Indirect*
Total Expenditures: Grantee Level
PLANNED PROJECT OPERATOR EXPENDITURES
Career Services
Training
Work-Based Learning
Supportive Services
Needs-Related Payments
Other
Admin (Excluding NRP Processing)
NRP Processing
Total: Program Management and Oversight
Total: Expenditures: Project Operator Level
Total: Expenditures: Grantee and Project Operator Level
Public Burden Statement:
Persons are not required to respond to this collection of information unless it displays a currently valid OMB Control number. Respondents’ obligation to complete this form is required to obtain or retain benefits (PL 113-128 sec 170). Public reporting burden for this collection of information is estimated to average 90 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This is public information and there is no expectation of confidentiality. Send comments regarding this burden estimate to the U.S. Department of Labor, Office of National Response, Room C-5311, Washington, D.C. 20210 (Paperwork Reduction Project 1205-0439).