Form ETA 6-131 A & B ETA 6-131 A & B Disciplinary Discharge and Review Board Hearings

OMB Control Number: 1205-0219
Expires: 05/31/2025
Public Burden Statement
ETA 6-131A

Sex:
Age: 18
Incidents
Incident lnformat.ion:

D

0612512009!.Y;J)

Date:
Time:

Student Hotified

00:00 AM ;

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Location:
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TYJ>e: Level I Infraction

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•
DescriI>tion: Level II Infraction
Level Ill Infraction
ReI>orting Staff: Positive

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Comment:

Pending Re1>orts

[student Conduct Incident Report !

6-131A Disciplinary Discharge, 6-131B Review Board Hearings, 6-131C Rights to Appeals:
Replaced by the following Student Conducts data entry screens
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to this collection of information unless it displays a currently valid OMB control number.
Respondents' obligation to complete this form is required to obtain or retain benefits (P.L.
113-128). Public reporting burden is estimated to average 20 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the collection of
Information. Send comments regarding this burden estimate to the U.S. Department of
Labor, Division of Adult Services, Room S-4209, Washington, D.C. 20210 (Paperwork
Reduction Project 1205-0219). Please do not submit completed forms to this address.

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