COVID Symptom Tracker and Emotional Wellness Forms Collection

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
2. 887660 - ATTACHMENT 1 - Signed.pdf	Supplementary Document	Uploaded 2020-11-23	Repair queued
1205-0NEW COVID Sympton Tracker and Emotional Wellness Supporting Statement 111320.docx	Supporting Statement A	Uploaded 2020-11-13	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
244486	COVID 19 Emotional Wellness -- Students	Other-Checklist	New
244485	COVID-19 Symptom Tracker -- Staff	Other-Checklist	New
244484	COVID-19 Symptom Tracker -- Students	Other-Checklist	New

ICR Details

OMB Control No:	ICR Reference No: 202011-1205-002
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: DOL/ETA	Agency Tracking No:
Title: COVID Symptom Tracker and Emotional Wellness Forms Collection
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 12/01/2020
Date Submitted to OIRA: 11/23/2020

table that charts list comparision

	Requested	Previously Approved
Expiration Date	6 Months From Approved
Responses	9,464,000	0
Time Burden (Hours)	312,312	0
Cost Burden (Dollars)	0	0

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Abstract: This ICR seeks to obtain permission to collect information to assess the impact of the novel coronavirus and reduce the risk of spread amongst the Job Corps students and staff. The Employment and Training Administration (ETA) has determined that this information is essential to the decision to resume physical operation of Job Corps centers.

Emergency Justfication: This ICR seeks to obtain permission to collect information to assess the impact of the novel coronavirus and reduce the risk of spread amongst the Job Corps students and staff. The Employment and Training Administration (ETA) has determined that this information is essential to the decision to resume physical operation of Job Corps centers.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
COVID-19 Symptom Tracker -- Students
COVID 19 Emotional Wellness -- Students
COVID-19 Symptom Tracker -- Staff

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	9,464,000	0	0	9,464,000	0	0
Annual Time Burden (Hours)	312,312	0	0	312,312	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Yes

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/23/2020

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