Information Collection

Joint WIOA Participant Individual Record Layout (PIRL) IC (ETA 9170)

IC 221368 under ICR 202509-1205-010 · OMB 1205-0526.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 9170 WIOA PIRL Joint WIOA Participant Individual Record Layout (PIRL) IC (ETA 9170)	Form
Instructions - WIOA Wage Conversion Chart - 123020.xlsx	Instruction
Instructions - WIOA Wage Conversion Chart - 123020.xlsx	Instruction
Effectiveness in Serving Employers Specs - 123020.docx	Instruction
Effectiveness in Serving Employers Specs - 123020.docx	Instruction
ETA 9170 WIOA PIRL ETA_9170 Nonmaterial 2025.xlsx	Form
ETA 9170 WIOA PIRL ETA_9170 Nonmaterial 2025.xlsx	Form
ETA-9170_(changes) 12.4.17.xlsx Amended WIOA PIRL_ETA-9170	IC Document
ETA-9170_(changes) 12.4.17.xlsx Amended WIOA PIRL_ETA-9170	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? Yes

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 677

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction		Yes	No	Printable Only
Instruction		Yes	No	Printable Only
Form	ETA 9170	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 249

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	249	249
Annual IC Time Burden (Hours)	113	113
Annual IC Cost Burden (Dollars)	33,300,000	33,300,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Amended WIOA PIRL_ETA-9170		12/29/2017

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].