SSA Survey (Census)

Student Safety Assessment of Job Corps Centers

Documents and Forms

Document Name Document Type
1205-0542 SSA Appendix A English Script.docx Other-Survey
1205-0542 SSA Appendix A English Script - Clean 4.11.24.docx Other-Survey
1205-0542 SSA Appendix B Spanish Script.docx Other-Survey
1205-0542 SSA Appendix B Spanish Script.docx Other-Survey

Information Collection (IC) Details

IC Title:	SSA Survey (Census)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 7 29 CFR 70

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			1205-0542 SSA Appendix A English Script - Clean 4.11.24.docx		Yes	Yes	Fillable Fileable
Other-Survey			1205-0542 SSA Appendix B Spanish Script.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: Job Corps Student Records (DOL/GOVT-2)	FR Citation: 67 FR 16815

Number of Respondents: 22,100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	88,400	88,400
Annual IC Time Burden (Hours)	22,100	22,100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.