Self-Employment Assistance (SEA) Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form ETA-9161 Self-Employment Assistance	Form and Instruction	Modified	Repair queued
Form ETA-9161 State Reporting, Self-Employment Assistance	Form and Instruction	Modified	Available
Form ETA-9161 Self-Employment Assistance	Form and Instruction	Modified	Available
Form ETA-9161 Participant Disclosures to States	Form and Instruction	Modified	Repair queued
Form ETA 9161 Self-Employment Assistance	Form and Instruction	Modified	Repair queued
Form ETA 9161 State Records on Participants	Form and Instruction	Modified	Repair queued
1205-0490 Supporting Statement_11.1.24.docx	Supporting Statement A	Uploaded 2024-12-05	Available
1205-0490 Supporting Statement_11.1.24.docx	Supporting Statement A	Uploaded 2024-12-05	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
201520	State Reporting, Self-Employment Assistance	Form and Instruction	Modified	Self-Employment Assistance
201520	State Reporting, Self-Employment Assistance	Form and Instruction	Modified
201511	Participant Disclosures to States	Form and Instruction	Modified	Self-Employment Assistance
201511	Participant Disclosures to States	Form and Instruction	Modified
201509	State Records on Participants	Form and Instruction	Modified	Self-Employment Assistance
201509	State Records on Participants	Form and Instruction	Modified

ICR Details

OMB Control No: 1205-0490	ICR Reference No: 202410-1205-008
Status: Active	Previous ICR Reference No: 202112-1205-012
Agency/Subagency: DOL/ETA	Agency Tracking No:
Title: Self-Employment Assistance (SEA) Program
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/11/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/12/2024
Terms of Clearance: OMB is approving this information collection request for a period of three years during which time the agency will request approval to extend or revise the collection if the agency seeks to continue the information collection activity beyond the period approved under this action.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2029	36 Months From Approved	02/28/2026
Responses	17,616	0	27,220
Time Burden (Hours)	8,832	0	13,640
Cost Burden (Dollars)	0	0	0

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Abstract: Reporting Form ETA-9161, Self-Employment Assistance, includes information about people who enter the SEA program and the benefits they receive and some limited outcome data. These data are used for oversight and to provide data responsive to statutorily required evaluations of this program. A State summarizes information collected from SEA program participants to prepare the reports.

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Authorizing Statute(s): PL: Pub.L. 112 - 96 2183(b)(1) Name of Law: Middle Class Tax Relief and Job Creation Act of 2012
   US Code: 42 USC 503(a)(6) Name of Law: Social Security Act
   PL: Pub.L. 105 - 306 3 Name of Law: Noncitizen Benefit Clarification and Other Technical Amendments Act of 1998
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 57432	07/15/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 100542	12/12/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Participant Disclosures to States	ETA-9161	Self-Employment Assistance
State Records on Participants	ETA 9161	Self-Employment Assistance
State Reporting, Self-Employment Assistance	ETA-9161	Self-Employment Assistance

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	17,616	27,220	0	-9,604	0	0
Annual Time Burden (Hours)	8,832	13,640	0	-4,808	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The change in burden to the states is due to the following since the last renewal; a decrease in the number of participants, the average wage of a state workforce agency employee, and the seasonally adjusted national average hourly wage of all employees on private nonfarm payroll.

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Annual Cost to Federal Government: $34,869

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/12/2024

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