Eta-9042, Eta-9042a

Petition Requirements; Investigations; Domestic Industry Study; Application for Reconsideration

Documents and Forms

Document Name Document Type
Form ETA 9042 ETA-9042, ETA-9042A Form and Instruction
ETA 9042 Petition for TAA ETA-9042 Petition for TAA - English.docx Form and Instruction
ETA 9042 Petition for TAA ETA-9042 Petition for TAA - Spanish.docx Form and Instruction
ETA-9042 EBSS Petition Screenshots.docx Screen shots IC Document
ETA-9042 Webapp Test Petition.pdf Web App Test Petition IC Document

Information Collection (IC) Details

IC Title:	ETA-9042, ETA-9042A	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA 9042	Petition for TAA	ETA-9042 Petition for TAA - English.docx		Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9042	Petition for TAA	ETA-9042 Petition for TAA - Spanish.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Screen shots	ETA-9042 EBSS Petition Screenshots.docx	08/21/2020
Web App Test Petition	ETA-9042 Webapp Test Petition.pdf	08/21/2020

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