Document
U
ICR 201909-1205-004 · OMB 1205-0439 · Object 94663901.
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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 (Disaster-Temporary Jobs), ETA 9103-2a 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 Employed in Temporary Disaster Relief Assistance Receiving Supportive Services Completed NDWG Services Employed at Completion of NDWG Services Total Planned Participants PLANNED GRANTEE EXPENDITURES Administrative Other Total: Program Management and Oversight Indirect* Total Expenditures: Grantee Level PLANNED PROJECT OPERATOR EXPENDITURES Participant Wages Participant Fringe Benefits Career Services Supportive Services Other Administrative 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).