Program Status Summary

Reporting and Performance Standards System for Migrant and Seasonal Farmworker Programs

Documents and Forms

Document Name Document Type
Form ETA 9095 Program Status Summary Form and Instruction
ETA 9095 NFJP Program Status Summary Report FINAL_NFJP PSS Form 9095 2.26.16.docx www.doleta.gov/MSFW/pdf/Program-Status-Report-Form-9095.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Program Status Summary	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA 9095	NFJP Program Status Summary Report	FINAL_NFJP PSS Form 9095 2.26.16.docx	http://www.doleta.gov/MSFW/pdf/Program-Status-Report-Form-9095.pdf	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 52	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	208	208
Annual IC Time Burden (Hours)	3,536	3,536
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.