Benefit Appeals Report -- Extended Benefits (ETA 5130)

Benefit Appeals Report

OMB: 1205-0172

IC ID: 239600

Information Collection (IC) Details

View Information Collection (IC)

Benefit Appeals Report -- Extended Benefits (ETA 5130)
 
No New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction ETA 5130 BENEFIT APPEALS REPORT SectionI_ClaimantActivity_ETA 5130 030320.docx Yes Yes Fillable Fileable

Income Security Unemployment Compensation

 

53 0
   
State, Local, and Tribal Governments
 
   100 %

  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 636 0 636 0 0 0
Annual IC Time Burden (Hours) 636 0 636 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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