Information Collection

Federal-State EB Claimants

IC 219248 under ICR 202507-1205-001 · OMB 1205-0177.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA-218 Federal-State EB Claimants	Form and Instruction
Form ETA-218 Benefits Rights and Experience Federal-State EB Claimants	Form and Instruction
ETA-218 Benefits Rights and Experience SectionI_ClaimantActivity_ETA 218.docx	Form and Instruction
ETA-218 Benefits Rights and Experience SectionI_ClaimantActivity_ETA 218.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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA-218				Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2

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
	Approved	Previously Approved
Annual Number of Responses for this IC	4	4
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	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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