Workforce Innovation and Opportunity Act: National Emergency Grant (NEG) Assistance-Application and Reporting Procedures

National Dislocated Workers Emergency Grant Application and Reporting Procedures

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0439 can be found here:

Documents and Forms

Document Name Document Type
Form ETA 9103-1 Workforce Innovation and Opportunity Act: National Emergency Grant (NEG) Assistance-Application and Reporting Procedures Form
ETA 9103-1 Planning Form (Regular) Planning Form ETA 9103-1_FINAL 9.5.19.doc Form
ETA 9103-2a Planning Form (Disaster-Temporary Jobs) Planning Form ETA 9103-2a_FINAL 9.5.19.doc Form
ETA 9103-2b Planning Form (Disaster Workforce Development Services) Planning Form ETA 9103-2b_FINAL 9.5.19.doc Form
ETA 9103-3 Planning Form (Dual Enrollment) Planning Form ETA 9103-3_FINAL 9.5.19.doc Form
ETA 9104 Quarterly Performance Report Quarterly Performance Report Form ETA 9104_FINAL 9.5.19.doc Form
ETA 9105 Employer Data Form Employer Data Form ETA 9105_FINAL 9.5.19.doc Form
ETA 9106 Project Synopsis Form Project Synopsis Form ETA 9106_FINAL 9.5.19.doc Form
ETA 9107 Project Operator Data Form Project Operator Data Form ETA 9107_FINAL 9.5.19.doc Form

Information Collection (IC) Details

IC Title:	Workforce Innovation and Opportunity Act: National Emergency Grant (NEG) Assistance-Application and Reporting Procedures	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 687.150

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA 9103-1	Planning Form (Regular)	Planning Form ETA 9103-1_FINAL 9.5.19.doc	Yes	Yes	Fillable Fileable
Form	ETA 9103-2a	Planning Form (Disaster-Temporary Jobs)	Planning Form ETA 9103-2a_FINAL 9.5.19.doc	Yes	Yes	Fillable Fileable
Form	ETA 9103-2b	Planning Form (Disaster Workforce Development Services)	Planning Form ETA 9103-2b_FINAL 9.5.19.doc	Yes	Yes	Fillable Fileable
Form	ETA 9103-3	Planning Form (Dual Enrollment)	Planning Form ETA 9103-3_FINAL 9.5.19.doc	Yes	Yes	Fillable Fileable
Form	ETA 9104	Quarterly Performance Report	Quarterly Performance Report Form ETA 9104_FINAL 9.5.19.doc	Yes	Yes	Fillable Fileable
Form	ETA 9105	Employer Data Form	Employer Data Form ETA 9105_FINAL 9.5.19.doc	Yes	Yes	Fillable Fileable
Form	ETA 9106	Project Synopsis Form	Project Synopsis Form ETA 9106_FINAL 9.5.19.doc	Yes	Yes	Fillable Fileable
Form	ETA 9107	Project Operator Data Form	Project Operator Data Form ETA 9107_FINAL 9.5.19.doc	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 159	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,587	1,587
Annual IC Time Burden (Hours)	1,086	1,086
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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