OMB control number
Migrant and Seasonal Farmworker Monitoring Report and Complaint/Apparent Violation Form
OMB 1205-0039 · DOL/ETA.
OMB 1205-0039
This information collection relates to the Wagner-Peyser Act, published January 6, 2020, which gives States increased flexibility in their administration of Employment Service activities funded under the Wagner-Peyser Act. The regulations align with the flexibility allowed under the Workforce Innovation and Opportunity Act (WIOA). Pursuant to 20 CFR 653.109, SWAs use ETA Form 5148 to submit quarterly data to ETA on the services they provide to MSFWs. ETA uses that data to monitor and measure the extent and effectiveness of SWA service delivery to MSFWs and overall compliance with 20 CFR 651, 653, and 658. Additionally, 20 CFR 658.602(e) requires the ETA National Office to develop tools and techniques for reviewing and assessing SWA performance and compliance with ES regulations; and 20 CFR 658.602(f)(2) requires the National Monitor Advocate to review the performance of SWAs in providing the full range of employment services to MSFWs. The collection of data through ETA Form 5148 allows ETA to comply with these regulations and monitor SWA performance. ETA requires that staff must ensure a complainant (or his/her representative) submits a complaint on the Complaint/Apparent Violation Form or another complaint form prescribed or approved by the Department or submits complaint information. The Complaint/Apparent Violation Form must be used for all complaints, including complaints about unlawful discrimination. ETA Form 8429 is helpful because it identifies whether a complainant is a Migrant and Seasonal Farmworker which implicates additional actions that must be taken.
The latest form for Migrant and Seasonal Farmworker Monitoring Report and Complaint/Apparent Violation Form expires 2027-03-31 and is listed under ICR 202402-1205-002.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form ETA 8429 Outreach Log Maintenance | Form |
| Form ETA 5148 Program Monitoring Reporting and Recordkeeping (ETA 5148) | Form |
| Form ETA 8429 Job Service Complaint Reporting and Third Party Disclosure (ETA 8429) | Form |
| SOC Code 21-1012.pdf | Supplementary Document |
| 1205-0039 Supporting Statement clean - 12.4.docx | Supporting Statement A |
 Complaint Log |
Information collection |
| Outreach Log Maintenance |
Form |
| Program Monitoring Reporting and Recordkeeping (ETA 5148) |
Form |
| Job Service Complaint Reporting and Third Party Disclosure (ETA 8429) |
Form |
All Historical Document Collections
OMB Details
Job Service Complaint Reporting and Third Party Disclosure (ETA 8429)
Federal Enterprise Architecture: Workforce Management - Training and Employment
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form ETA 8429 | Compliant-Apparent Violation Form | Fillable Fileable | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.