Senior Community Service Employment Program (SCSEP)

OMB 1205-0040

The Senior Community Service Employment Program (SCSEP), is a community service and work-based training program for older workers. The program provides subsidized, work-experience training for low-income persons 55 or older who are unemployed and have poor employment prospects. SCSEP national grants are awarded through a competitive process; state and territorial grants are awarded through a formula outlined in the OAA-2016 Section 506 (b-c). The dual goals of the program are to promote useful community service employment activities and to move SCSEP participants into unsubsidized employment, so that they can achieve economic self-sufficiency. The Department is required to collect the information in order to comply with the OAA statutory and regulatory requirements. The information is also necessary for grantee performance accountability and program management.

The latest form for Senior Community Service Employment Program (SCSEP) expires 2021-11-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form ETA 9124A Participant Customer Satisfaction – ETA-9124A Form
Form ETA 9120, ETA 9121 ETA 5140 and ETA 9191 Form and Instruction
Form ETA 8705B Grantee Equitable Distribution Report Form
Form ETA 9124C2 Employer Customer Satisfaction – ETA-9124C2 Form
Form ETA 9124C2 Non-Host Agency Employer Survey Pilot Project -- ETA-9124C2 Form
Form ETA 9124B Host Agency Customer Satisfaction – ETA-9124B Form
Form ETA 9124C1 Employer Customer Satisfaction – ETA-9124C1 Form and Instruction
SCSEP CSS 1205-0040 Supporting Statement Part B_ clean.docx Supporting Statement B
signed_PRA Signature Form_SCSEP_(2024_0206).pdf Supplementary Document
Additional Context for ICR Changes 10.18.21.docx Supplementary Document
signed_PRA Signature Form_SCSEP_(2021_1001).pdf Supplementary Document
1205-0040 Supporting Statement - clean.docx Supporting Statement A
Participant Customer Satisfaction – ETA-9124A Form
ETA 5140 and ETA 9191 Form and Instruction
Grantee Equitable Distribution Report Form
Employer Customer Satisfaction – ETA-9124C2 Form
Non-Host Agency Employer Survey Pilot Project -- ETA-9124C2 Form
Participant Survey Pilot Project -- ETA-9124A Instruction
Host Agency Customer Satisfaction – ETA-9124B Form
Employer Customer Satisfaction – ETA-9124C1 Form and Instruction

All Historical Document Collections

202401-1205-001	Revision of a currently approved collection	2024-04-18
202108-1205-007 Approved with change	Revision of a currently approved collection	2021-10-18
201808-1205-001 Approved without change	Revision of a currently approved collection	2018-08-31
201608-1205-001 Withdrawn and continue	No material or nonsubstantive change to a currently approved collection	2016-08-09
201603-1205-006 Approved without change	No material or nonsubstantive change to a currently approved collection	2016-03-21
201601-1205-002 Withdrawn and continue	No material or nonsubstantive change to a currently approved collection	2016-03-01
201509-1205-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2015-10-17
201411-1205-004 Approved with change	Revision of a currently approved collection	2015-03-31
201207-1205-003 Approved without change	No material or nonsubstantive change to a currently approved collection	2012-07-10
201203-1205-010 Approved without change	Revision of a currently approved collection	2012-03-29
201104-1205-005 Preapproved	Revision of a currently approved collection	2012-01-26
201103-1205-009 Approved without change	Reinstatement with change of a previously approved collection	2011-03-30
201010-1205-008 Withdrawn	Revision of a currently approved collection	2010-10-29
200806-1205-007 Approved without change	No material or nonsubstantive change to a currently approved collection	2008-06-20
200704-1205-001 Approved without change	Revision of a currently approved collection	2007-07-05
200606-1205-001 Approved without change	Revision of a currently approved collection	2006-06-13
200509-1205-004 Approved with change	Revision of a currently approved collection	2005-09-06
200410-1205-005 Approved without change	No material or nonsubstantive change to a currently approved collection	2004-10-29
200406-1205-004 Approved without change	No material or nonsubstantive change to a currently approved collection	2004-06-23
200404-1205-001 Approved with change	Revision of a currently approved collection	2004-04-08
200312-1205-003 Approved without change	Revision of a currently approved collection	2003-12-29
200304-1205-002 Comment filed on proposed rule and continue	Revision of a currently approved collection	2003-04-28
200006-1205-002 Approved without change	Reinstatement with change of a previously approved collection	2000-06-09
199411-1205-003 Approved without change	Reinstatement without change of a previously approved collection	1994-11-28
199107-1205-005 Approved without change	Revision of a currently approved collection	1991-07-25
198904-1205-003 Approved without change	Revision of a currently approved collection	1989-04-06
198806-1205-003 Approved with change	No material or nonsubstantive change to a currently approved collection	1988-06-08
198512-1205-005 Approved with change	No material or nonsubstantive change to a currently approved collection	1985-12-23
198508-1205-002 Approved without change	Reinstatement with change of a previously approved collection	1985-08-05
197802-1205-001 Approved without change	Extension without change of a currently approved collection	1978-02-01
197801-1205-004 Approved without change	Extension without change of a currently approved collection	1978-01-31
197512-1205-001 Approved without change	New collection (Request for a new OMB Control Number)	1975-12-11

OMB Details

SCSEP Participant Data Form

Federal Enterprise Architecture: Community and Social Services - Community and Regional Development

Form ETA 9120

SPARQ Participant Form

Fillable Fileable

Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.