OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Benefit Appeals Report

OMB 1205-0172 ยท DOL/ETA.

OMB 1205-0172

The ETA 5130, Benefit Appeals Report, contains information on the number of appeals and the resultant decisions classified by program, appeal level, cases filed and disposed of (workload flow), and decisions by level, appellant and issue. The data on this form are used to monitor the benefit appeals process in the state workforce agencies (SWAs). Data are also used for budgeting and workload data.

The latest form for Benefit Appeals Report expires 2026-07-31 and is listed under ICR 202304-1205-005.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form ETA 5130 Benefit Appeals ReportForm and Instruction
Form ETA 5130 Benefit Appeals ReportForm and Instruction
Comment on ETA5130 Benefit Appeals Report (OMB Control No 1205 0172).msgPublic Comments
Benefit Appeals Report _6.22.26.docxSupporting Statement A
Benefit Appeals Report -- Extended Benefits (ETA 5130) Form and Instruction
Benefit Appeals Report (ETA 5130 REG) Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202603-1205-004 Extension without change of a currently approved collection 2026-06-26
202304-1205-005 Extension without change of a currently approved collection 2023-05-12 Approved with change
202001-1205-003 Extension without change of a currently approved collection 2020-05-18 Approved without change
201611-1205-004 Revision of a currently approved collection 2017-02-06 Approved without change
201305-1205-001 Extension without change of a currently approved collection 2014-01-22 Approved with change
201010-1205-003 Extension without change of a currently approved collection 2010-11-30 Approved without change
200709-1205-003 Extension without change of a currently approved collection 2007-10-09 Approved without change
200410-1205-001 Extension without change of a currently approved collection 2004-10-18 Approved without change
200108-1205-003 Extension without change of a currently approved collection 2001-08-16 Approved without change
199808-1205-003 Extension without change of a currently approved collection 1998-08-17 Approved without change
199506-1205-015 Revision of a currently approved collection 1995-06-27 Approved without change
199206-1205-001 Extension without change of a currently approved collection 1992-06-22 Approved without change
198906-1205-002 Extension without change of a currently approved collection 1989-06-27 Approved without change
198708-1205-003 Extension without change of a currently approved collection 1987-08-18 Approved without change
198606-1205-002 Extension without change of a currently approved collection 1986-06-03 Approved without change
198401-1205-004 Reinstatement with change of a previously approved collection 1984-01-17 Approved without change
198110-1205-012 New collection (Request for a new OMB Control Number) 1981-10-30 Approved without change

OMB Details

Benefit Appeals Report (ETA 5130 REG)

Federal Enterprise Architecture: Income Security - Unemployment Compensation

Information collection instruments
FormNameElectronic accessType
Form ETA 5130Benefit Appeals ReportFillable FileableForm and instruction

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