Claims and Payment Activities

OMB 1205-0010

The Form ETA-5159 report provides important program information on claims taking and benefit payment activities under state/federal unemployment insurance laws. These data are needed for budget preparation and control, program planning and evaluation, personnel assignment, actuarial and program research, and for accounting to Congress and the public. This collection is authorized under the Social Security Act, Title III, Section 303(a)(6) and PL 112-96.

The latest form for Claims and Payment Activities expires 2022-04-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form ETA 5159 Claims and Payment Activities Form and Instruction
1205-0010 Supporting Statement 2.14.2022 FINAL.docx Supporting Statement A
Claims and Payment Activities Form and Instruction

All Historical Document Collections

202112-1205-007 Approved without change	Extension without change of a currently approved collection	2022-02-14
201811-1205-001 Approved without change	Extension without change of a currently approved collection	2019-03-01
201508-1205-003 Approved without change	Revision of a currently approved collection	2015-10-14
201208-1205-004 Approved without change	Extension without change of a currently approved collection	2012-09-24
201203-1205-012 Approved without change	Revision of a currently approved collection	2012-04-06
200911-1205-005 Approved without change	No material or nonsubstantive change to a currently approved collection	2009-11-17
200907-1205-001 Approved without change	Extension without change of a currently approved collection	2009-07-24
200903-1205-003 Approved without change	No material or nonsubstantive change to a currently approved collection	2009-03-18
200603-1205-003 Approved with change	Revision of a currently approved collection	2006-03-22
200303-1205-002 Approved without change	Extension without change of a currently approved collection	2003-03-18
200001-1205-002 Approved without change	Revision of a currently approved collection	2000-01-20
199703-1205-004 Approved without change	Revision of a currently approved collection	1997-03-25
199506-1205-018 Approved without change	Revision of a currently approved collection	1995-06-30
199310-1205-002 Approved without change	Revision of a currently approved collection	1993-10-27
199010-1205-003 Approved without change	Revision of a currently approved collection	1990-10-01
198709-1205-002 Approved without change	Revision of a currently approved collection	1987-09-01
198605-1205-005 Approved without change	Revision of a currently approved collection	1986-05-30
198411-1205-003 Approved without change	Extension without change of a currently approved collection	1984-11-28
198406-1205-006 Approved without change	Extension without change of a currently approved collection	1984-06-11
198203-1205-008 Approved without change	Revision of a currently approved collection	1982-03-25
197906-1205-003 Approved without change	Revision of a currently approved collection	1979-06-19
197701-1205-002 Approved with change	No material or nonsubstantive change to a currently approved collection	1977-01-25
197609-1205-004 Approved without change	Revision of a currently approved collection	1976-09-29
197511-1205-004 Approved without change	Extension without change of a currently approved collection	1975-11-18