Joint WIOA Participant Individual Record Layout (PIRL) IC (ETA 9170)

Workforce Innovation and Opportunity Act (WIOA) Common Performance Reporting

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0526 can be found here:

Documents and Forms

Document Name Document Type
Instructions - WIOA Wage Conversion Chart - 123020.xlsx Instruction
Instructions - WIOA Wage Conversion Chart - 123020.xlsx Instruction
Effectiveness in Serving Employers Specs - 123020.docx Instruction
Effectiveness in Serving Employers Specs - 123020.docx Instruction
ETA-9170 WIOA PIRL ETA_9170 10.15.20.xlsx Form
ETA-9170 WIOA PIRL ETA_9170 10.15.20.xlsx Form
ETA-9170_(changes) 12.4.17.xlsx Amended WIOA PIRL_ETA-9170 IC Document
ETA-9170_(changes) 12.4.17.xlsx Amended WIOA PIRL_ETA-9170 IC Document

Information Collection (IC) Details

IC Title:	Joint WIOA Participant Individual Record Layout (PIRL) IC (ETA 9170)	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 677

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Instructions - WIOA Wage Conversion Chart - 123020.xlsx	Yes	No	Printable Only
Form	ETA-9170	WIOA PIRL	ETA_9170 10.15.20.xlsx	Yes	Yes	Fillable Fileable
Instruction			Effectiveness in Serving Employers Specs - 123020.docx	Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 249	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	19,102,174	0	19,102,174
Annual IC Time Burden (Hours)	5,013,443	0	5,013,443
Annual IC Cost Burden (Dollars)	34,594,532	3,636,772	30,957,760

Documents for IC

Title	Document	Date Uploaded
Amended WIOA PIRL_ETA-9170	ETA-9170_(changes) 12.4.17.xlsx	12/29/2017

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