OMB
.report
Search
WIOA Statewide Performance Report Template and WIOA Local Performance Report Template IC (ETA-9169)
Workforce Innovation and Opportunity Act (WIOA) Common Performance Reporting
OMB: 1205-0526
IC ID: 221306
OMB.report
DOL/ETA
OMB 1205-0526
ICR 202402-1205-004
IC 221306
( )
Documents and Forms
Document Name
Document Type
Instructions - WIOA Wage Conversion Chart - 123020.xlsx
Instruction
Instructions - WIOA Wage Conversion Chart - 123020.xlsx
Instruction
Effectiveness in Serving Employers Specs - 123020.docx
Instruction
Effectiveness in Serving Employers Specs - 123020.docx
Instruction
ETA 9169 WIOA Statewide and Local Performance Report Template
ETA_9169 2.7.24 CLEAN.xlsx
Form
ETA 9169 WIOA Statewide and Local Performance Report Template
ETA_9169 2.7.24 CLEAN.xlsx
Form
ETA_9169 2.7.24.xlsx
WOIA Statewide and Local Performance Report - track changes
IC Document
ETA_9169 2.7.24.xlsx
WOIA Statewide and Local Performance Report - track changes
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
WIOA Statewide Performance Report Template and WIOA Local Performance Report Template IC (ETA-9169)
Agency IC Tracking Number:
Is this a Common Form?
Yes
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 677
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
Instructions - WIOA Wage Conversion Chart - 123020.xlsx
Yes
No
Printable Only
Instruction
Effectiveness in Serving Employers Specs - 123020.docx
Yes
No
Printable Only
Form
ETA 9169
WIOA Statewide and Local Performance Report Template
ETA_9169 2.7.24 CLEAN.xlsx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
249
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 New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
249
0
0
0
0
249
Annual IC Time Burden (Hours)
1,110
0
0
0
0
1,110
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
WOIA Statewide and Local Performance Report - track changes
ETA_9169 2.7.24.xlsx
02/09/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.