Information Collection

ICON Application, EBCDIC Format

IC 205854 under ICR 202509-1205-005 · OMB 1205-0510.

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Information Collection (IC) Details

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IC Title:	ICON Application, EBCDIC Format	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 619.3 20 CFR 619.2 20 CFR 619.4 20 CFR 625 appendix B

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	12	-3	15
Annual IC Time Burden (Hours)	1,440	-360	1,800
Annual IC Cost Burden (Dollars)	95,755	-203,489	299,244

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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