Claims and Payment Activities

ICR 202112-1205-007

OMB: 1205-0010

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2022-02-14
IC Document Collections
IC ID
Document
Title
Status
12927 Modified
ICR Details
1205-0010 202112-1205-007
Received in OIRA 201811-1205-001
DOL/ETA
Claims and Payment Activities
Extension without change of a currently approved collection   No
Regular 02/14/2022
  Requested Previously Approved
36 Months From Approved 04/30/2022
2,544 2,544
6,996 6,996
0 0

The Form ETA-5159 report provides important program information on claims taking and benefit payment activities under state/federal unemployment insurance laws. These data are needed for budget preparation and control, program planning and evaluation, personnel assignment, actuarial and program research, and for accounting to Congress and the public. This collection is authorized under the Social Security Act, Title III, Section 303(a)(6) and PL 112-96.

US Code: 42 USC 503(a)(6) Name of Law: Social Security Act
   PL: Pub.L. 112 - 96 2165(a)(3) Name of Law: Middle Class Tax Relief and Job Creation Act of 2012
  
None

Not associated with rulemaking

  86 FR 36161 07/08/2021
87 FR 8295 02/14/2022
Yes

1
IC Title Form No. Form Name
Claims and Payment Activities ETA 5159 Claims and Payment Activities

  Total Request 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 2,544 2,544 0 0 0 0
Annual Time Burden (Hours) 6,996 6,996 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$36,238
No
    No
    No
No
No
No
No
Emily St. Onge 202 693-2605 st.onge.emily@dol.gov

  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.
02/14/2022


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