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Placement Service
Placement Service
OMB: 3220-0057
IC ID: 33872
OMB.report
RRB
OMB 3220-0057
ICR 202311-3220-002
IC 33872
( )
Documents and Forms
Document Name
Document Type
Form ES-21 (11-07)
Placement Service
Form
ES-21 (11-07) Referral to State Employment Service
Form ES-21 (11-07).pdf
Form
ES-21 (11-07) Referral to State Employment Service
Form ES-21 (11-07).pdf
Form
UI-35 (08-23) Field Office Record of Claimant Interview
Form UI-35 (08-23).pdf
Form
UI-35 (08-23) Field Office Record of Claimant Interview
Form UI-35 (08-23).pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Placement Service
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 325
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
ES-21 (11-07)
Referral to State Employment Service
Form ES-21 (11-07).pdf
No
Paper Only
Form
UI-35 (08-23)
Field Office Record of Claimant Interview
Form UI-35 (08-23).pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Unemployment Compensation
Privacy Act System of Records
Title:
RRB-21, Railroad Unemployment and Sickness Insurance benfit System
FR Citation:
79 FR 58874
Number of Respondents:
7,080
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
7,080
0
0
0
0
7,080
Annual IC Time Burden (Hours)
864
0
0
0
0
864
Annual IC Cost Burden (Dollars)
0
0
0
0
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.