Information Collection

Unemployment Compensation for Ex-servicemembers (UCX) - ETA Handbook 384

IC 43788 under ICR 202206-1205-004 · OMB 1205-0176.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0176 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 843 Unemployment Compensation for Ex-servicemembers (UCX) - ETA Handbook 384	Form
ETA 843 Request for Military Document/Information For Unemployme ETA 843 Form.docx	Form
ETA 843 Request for Military Document/Information For Unemployme ETA 843 Form.docx	Form

IC Title:

Unemployment Compensation for Ex-servicemembers (UCX) - ETA Handbook 384

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	ETA 843	Request for Military Document/Information For Unemployment Compensation PurposesâUCX	ETA 843 Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 53

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,908	-803	2,711
Annual IC Time Burden (Hours)	159	-67	226
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.