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Work Site Description (existing grantees)
YouthBuild Reporting System
OMB: 1205-0464
IC ID: 201498
OMB.report
DOL/ETA
OMB 1205-0464
ICR 202108-1205-004
IC 201498
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0464 can be found here:
2024-08-22 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form ETA 9143
Work Site Description (existing grantees)
Form and Instruction
ETA 9143 Work Site Description and Annual Housing Census Forms
ETA-9143 Work Site Description and AHC forms_FINAL 7.20.18.pdf
Form and Instruction
ETA 9143 Work Site Description and Annual Housing Census Forms
ETA-9143 Work Site Description and AHC forms_FINAL 7.20.18.pdf
Form and Instruction
ETA 9143 Worksite Description and Annual Housing Census Form
YB ETA-9143 and AHC Form_4.12.docx
Form and Instruction
ETA 9143 Worksite Description and Annual Housing Census Form
YB ETA-9143 and AHC Form_4.12.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Work Site Description (existing grantees)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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 9143
Work Site Description and Annual Housing Census Forms
ETA-9143 Work Site Description and AHC forms_FINAL 7.20.18.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
ETA 9143
Worksite Description and Annual Housing Census Form
YB ETA-9143 and AHC Form_4.12.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
210
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
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
210
0
0
-210
0
420
Annual IC Time Burden (Hours)
105
0
0
-105
0
210
Annual IC Cost Burden (Dollars)
0
0
0
0
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.