WIN EMPLOYABILITY PLAN AND CERTIFICATION RECORD (ETA-596)

ICR 198409-1205-002

OMB: 1205-0156

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
1205-0156 198409-1205-002
Historical Active 198309-1205-004
DOL/ETA
WIN EMPLOYABILITY PLAN AND CERTIFICATION RECORD (ETA-596)
Revision of a currently approved collection   No
Regular
Approved without change 11/16/1984
Retrieve Notice of Action (NOA) 09/21/1984
  Inventory as of this Action Requested Previously Approved
09/30/1985 09/30/1985 09/30/1984
3,069 0 3,230
30,690 0 32,300
0 0 0

LOCAL WIN STAFF USE THIS FORM TO SUMMARIZE APPRAISAL AND EMPLOYABILITY PLAN INFORMATION, AND OBTAIN REGISTRANTS' SIGNATURES, INDICATING AGREEMENT WITH THE EMPLOYABILITY PLAN, SAU ASSURES THAT REGISTRANTS ARE CERTIFIED FOR SOCIAL SERVICES. IT IS USED BY SAU AND E&T AGENCIES TO EXCHANGE INFORMATION.

None
None


No

1
IC Title Form No. Form Name
WIN EMPLOYABILITY PLAN AND CERTIFICATION RECORD (ETA-596) ETA-596

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,069 3,230 0 -161 0 0
Annual Time Burden (Hours) 30,690 32,300 0 -1,610 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/21/1984


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