Information Collection

New Hire: Employer Reporting Manually

IC 9955 under ICR 202507-0970-004 · OMB 0970-0166.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 New Hire: Employer Reporting Manually	Form and Instruction
Form 1 New Hire Input Record Specifications New Hire: Employer Reporting Manually	Form and Instruction
1 New Hire Input Record Specifications 0970-0166_NDNH_GDS_New_Hire_Input_Record_Specifications_v13_4.pdf	Form and Instruction
1 New Hire Input Record Specifications 0970-0166_NDNH_GDS_New_Hire_Input_Record_Specifications_v13_4.pdf	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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1				No		Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title: Location and Collection System

FR Citation: 70 FR 21200

Number of Respondents: 5,667,878

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 30 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	8,841,890	1,861,468	6,980,422
Annual IC Time Burden (Hours)	221,047	46,536	174,511
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.

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