Non-Host Agency Employer Survey Pilot Project -- ETA-9124C2

Senior Community Service Employment Program (SCSEP)

Documents and Forms

Document Name Document Type
Form ETA 9124C2 Non-Host Agency Employer Survey Pilot Project -- ETA-9124C2 Form
ETA 9124C2 Employer Survey ETA-9124C2_Employer Survey_Skip Question Version_Rev11523.pdf Form
ETA 9124C2 Employer Survey ETA-9124C2_Employer Survey_Skip Question Version_Rev11523.pdf Form

Information Collection (IC) Details

IC Title:	Non-Host Agency Employer Survey Pilot Project -- ETA-9124C2	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA 9124C2	Employer Survey	ETA-9124C2_Employer Survey_Skip Question Version_Rev11523.pdf		Yes	Yes	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: 750	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	750	673	77
Annual IC Time Burden (Hours)	120	97	23
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.