Job Corps Health Questionnaire

Job Corps Health Questionnaire

OMB: 1205-0033

IC ID: 12954

Documents and Forms
Information Collection (IC) Details

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Job Corps Health Questionnaire
No Modified
Required to Obtain or Retain Benefits
20 CFR 670.965

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction ETA 653 Job Corps Health Questionnaire Form ETA 653 BAH version.docx Yes Yes Fillable Fileable

Workforce Management Training and Employment

DOL/GOVT-2  81 FR 25765

66,630 0
Individuals or Households
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 66,630 0 0 0 0 66,630
Annual IC Time Burden (Hours) 8,884 0 0 0 0 8,884
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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