Information Collection Request

Placement Service

ICR 202311-3220-002 · OMB 3220-0057 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form ES-21 (11-07) Placement Service Form Modified Repair queued
Form ES-21c (07-05) Report of State Employment Service Office Form Unchanged Repair queued
3220-0057 .docx Supporting Statement A Uploaded 2023-11-30 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
33872 Placement Service Form Modified
181794 Report of State Employment Service Office Form Unchanged
181724 Railroad Job Vacancies List Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 12/31/2023
7,575 7,575
943 943
0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Placement Service ES-21 (11-07), UI-35 (08-23) Referral to State Employment Service ,   Field Office Record of Claimant Interview
Railroad Job Vacancies List
Report of State Employment Service Office ES-21c (07-05) Report of State Employment Service Office

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 7,575 7,575 0 0 0 0
Annual Time Burden (Hours) 943 943 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No