Information Collection

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

IC 232726 under ICR 202401-1205-001 · OMB 1205-0040.

Documents and Forms

Documents and forms in this information collection
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

IC Title:

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.