OMB control number

Program Reporting and Performance Standards System for Indian and Native American Programs Under Title I, Section 166 of the Workforce Innovation and Opportunity Act

OMB 1205-0422 · DOL/ETA.

OMB 1205-0422

OMB Control No. 1205-0422 contains two forms: ETA 9084, Comprehensive Services Program, and ETA 9085, Supplemental Youth Services Program. It also includes standard data elements for participants, the basis of the current performance standards system for WIOA section 166 grantees. ETA 9084 is completed by both tribal and non-profit private sector grantees. ETA 9085 is completed only by tribal grantees.

The latest form for Program Reporting and Performance Standards System for Indian and Native American Programs Under Title I, Section 166 of the Workforce Innovation and Opportunity Act expires 2023-03-31 and is listed under ICR 201912-1205-009.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form ETA-9085 Supplemental Youth Services Program Report (ETA 9085)	Form
Form ETA-9084 Comprehensive Services Program report (Form ETA-9084)	Form
1205-0422 Supporting Statement 012120.docx	Supporting Statement A
Supplemental Youth Services Program Report (ETA 9085)	Form
Standardized Participant Information Record (Tribal Government Grantees)	Instruction
Standardized Participant Information Record (Not-for-Profit Grantees)	Instruction
Comprehensive Services Program report (Form ETA-9084)	Form
Standardized Participant Information Record (Individual Participants)	Instruction
Comprehensive Services Program Report and Supplemental Youth Services Report (Forms ETA-9084 and ETA-9085) (Tribal Government Grantees)	Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
201912-1205-009	Revision of a currently approved collection	2020-01-31	Approved without change
201608-1205-003	Revision of a currently approved collection	2016-09-30	Approved without change
201511-1205-002	No material or nonsubstantive change to a currently approved collection	2016-02-09	Approved without change
201212-1205-006	Revision of a currently approved collection	2013-05-31	Approved with change
201001-1205-001	Extension without change of a currently approved collection	2010-04-20	Approved without change
200906-1205-001	Revision of a currently approved collection	2009-08-14	Approved without change
200609-1205-003	Revision of a currently approved collection	2006-10-11	Approved with change
200409-1205-004	Revision of a currently approved collection	2004-09-22	Approved without change
200307-1205-005	Extension without change of a currently approved collection	2003-07-30	Approved without change
200012-1205-008	New collection (Request for a new OMB Control Number)	2000-12-22	Approved without change

OMB Details

Comprehensive Services Program Report and Supplemental Youth Services Report (Forms ETA-9084 and ETA-9085) (Tribal Government Grantees)

Federal Enterprise Architecture: Workforce Management - Training and Employment

Information collection instruments
Form	Name	Electronic access	Type
Form ETA 9084	General Reporting Instructions for the Comprehensive Services Program Report and Standardized Participant Information Record Data	Fillable Fileable	Form and instruction
Form ETA 9085	General Reporting Instructions for the Supplemental Youth Services Program Report	Fillable Fileable	Form and instruction
Form 9085	Summer Youth Report Form	Fillable Fileable	Form

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