Information Collection Request

Self-Employment Assistance (SEA) Program

ICR 202112-1205-012 · OMB 1205-0490 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form ETA-9161 State Reporting, Self-Employment Assistance Form and Instruction Modified Repair queued
Form ETA-9161 Participant Disclosures to States Form and Instruction Modified Missing upstream
Form ETA 9161 State Records on Participants Form and Instruction Modified Repair queued
1205-0490 Supporting Statement 010322.docx Supporting Statement A Uploaded 2022-01-03 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
201520 State Reporting, Self-Employment Assistance Form and Instruction Modified
201511 Participant Disclosures to States Form and Instruction Modified
201509 State Records on Participants Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 04/30/2022
27,220 24,820
13,640 12,440
0 0





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3
table that charts list of burden
IC Title Form No. Form Name
Participant Disclosures to States ETA-9161 Self-Employment Assistance
State Records on Participants ETA 9161 Self-Employment Assistance
State Reporting, Self-Employment Assistance ETA-9161 Self-Employment Assistance

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 27,220 24,820 0 0 2,400 0
Annual Time Burden (Hours) 13,640 12,440 0 0 1,200 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No