Information Collection Request

Placement Service

ICR 202004-3220-002 · OMB 3220-0057 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Proposed UI-35 (xx Field Office Record of Claimant Interview Form Modified Available
Form UI-35 (03-07) Field Office Record of Claimant Interview Form Modified Repair queued
Form ES-21 (11-07) Referral to State Employment Service Form Modified Available
Form ES-21c (07-05) Report of State Employment Service Office Form Modified Available
3220-0057.docx Supporting Statement A Uploaded 2020-05-22 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
33872 Placement Service Form ModifiedField Office Record of Claimant Interview
33872 Placement Service Form ModifiedField Office Record of Claimant Interview
33872 Placement Service Form ModifiedReferral to State Employment Service
181794 Report of State Employment Service Office Form ModifiedReport of State Employment Service Office
181724 Railroad Job Vacancies List Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2023 36 Months From Approved 11/30/2020
7,575 0 11,325
943 0 953
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Placement Service Proposed UI-35 (xx-xx), ES-21 (11-07), UI-35 (03-07) ,   ,  
Railroad Job Vacancies List
Report of State Employment Service Office ES-21c (07-05)

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 7,575 11,325 0 -3,750 0 0
Annual Time Burden (Hours) 943 953 0 -10 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No