Information Collection

Distribution of Characteristics of the insured Unemployed

IC 12923 under ICR 202407-1205-002 · OMB 1205-0009.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 203 Distribution of Characteristics of the insured Unemployed	Form and Instruction
Att. B 203 Reasoning for 203 report.docx	Other-Report
Att. C ETA 203 report cell map.xlsx	Other-Report
ETA 203 Characteristics of the Unemployed ETA 401 HB-Report 203.docx	Form and Instruction

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA 203	Characteristics of the Unemployed	ETA 401 HB-Report 203.docx	Yes	Yes	Fillable Fileable
Other-Report			Att. B 203 Reasoning for 203 report.docx	Yes	Yes	Fillable Printable
Other-Report			Att. C ETA 203 report cell map.xlsx	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 53

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
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	636	0	636
Annual IC Time Burden (Hours)	426	214	212
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.