Information Collection

Certification Workload and Characteristic of Certified Individuals

IC 239192 under ICR 202302-1205-001 · OMB 1205-0371.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0371 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA-9058 Certification Workload and Characteristic of Certified Individuals	Form
ETA-9058 Certification Workload and Characteristic of Certified I ETA Form 9058 - Clean.rtf	Form
ETA-9058 Certification Workload and Characteristic of Certified I ETA Form 9058 - Clean.rtf	Form
ETA-9065 Audit Summary Worksheet ETA Form 9065 - Audit Summary Wrksht ADVR [clean edit].docx	Form
ETA-9065 Audit Summary Worksheet ETA Form 9065 - Audit Summary Wrksht ADVR [clean edit].docx	Form
ETA Form 9058 - redline edits.rtf Form 9058 - Tracked Changes	IC Document
ETA Form 9058 - redline edits.rtf Form 9058 - Tracked Changes	IC Document

IC Title:

Certification Workload and Characteristic of Certified Individuals

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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-9058	Certification Workload and Characteristic of Certified Individuals	ETA Form 9058 - Clean.rtf		Yes	Yes	Fillable Fileable
Form	ETA-9065	Audit Summary Worksheet	ETA Form 9065 - Audit Summary Wrksht ADVR [clean edit].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: 53

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	424	212	4	208
Annual IC Time Burden (Hours)	424	212	4	208
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Form 9058 - Tracked Changes	ETA Form 9058 - redline edits.rtf	02/14/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.