Employer Customer Satisfaction – ETA-9124C1

Senior Community Service Employment Program (SCSEP)

Documents and Forms

Document Name Document Type
Form ETA 9124C1 Employer Customer Satisfaction – ETA-9124C1 Form and Instruction
ETA 9124C1 Employer Survey ETA-9124C1_Employer Survey_Host Agency Version_Rev11523.pdf Form and Instruction
ETA 9124C1 Employer Survey ETA-9124C1_Employer Survey_Host Agency Version_Rev11523.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Employer Customer Satisfaction – ETA-9124C1	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR Part 641 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA 9124C1	Employer Survey	ETA-9124C1_Employer Survey_Host Agency Version_Rev11523.pdf		No		Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 825	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	825	-18,425	19,250
Annual IC Time Burden (Hours)	107	-2,973	3,080
Annual IC Cost Burden (Dollars)	0	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.