Information Collection

Work Site Description (existing grantees)

IC 201498 under ICR 202108-1205-004 · OMB 1205-0464.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0464 can be found here:

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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

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 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	210	-210	420
Annual IC Time Burden (Hours)	105	-105	210
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.