Information Collection Request
Benefit Appeals Report
ICR 202304-1205-005 · OMB 1205-0172 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1205-0172 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form ETA 5130 Benefit Appeals Report -- Extended Benefits (ETA 5130) |
Form and Instruction | Modified | Repair queued |
| Form ETA 5130 Benefit Appeals Report (ETA 5130 REG) |
Form and Instruction | Modified | Repair queued |
 1205-0172 Supporting Statement 050523 - Final.docx |
Supporting Statement A | Uploaded 2023-05-05 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 239600 |  Benefit Appeals Report -- Extended Benefits (ETA 5130) |
Form and Instruction | Modified | |
| 13008 | Benefit Appeals Report (ETA 5130 REG) |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DOL/ETA |
| OMB Control No | 1205-0172 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202001-1205-003 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |