Information Collection Request

Income and Eligibility Verification System Confidentiality

ICR 202509-1205-012 · OMB 1205-0238 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
ETA_OMB 1205-0238_Supporting statement_11.13.25.docx Supporting Statement A Uploaded 2025-11-13 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
206244 Income and Eligibility Verification, SSA data cross checking Modified
13069 Confidentiality and Disclosure of State UI Information, data matching Unchanged

ICR Details

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  Requested Previously Approved
36 Months From Approved 05/31/2026
374,233 421,178
9,951 10,749
0 0





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2
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IC Title Form No. Form Name
Confidentiality and Disclosure of State UI Information, data matching
Income and Eligibility Verification, SSA data cross checking

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 374,233 421,178 0 -46,945 0 0
Annual Time Burden (Hours) 9,951 10,749 0 -798 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No