Benefits Timeliness and Quality Review System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0359 can be found here:

Documents and Forms

Document Name Document Type
Form ETA-9050 Benefits Timeliness and Quality Review System Form and Instruction
ETA-9050 First Payment Lapse Report ETA 9050 First Payment Time Lapse Report.pdf Form and Instruction
ETA-9051 Continued Weeks Compensated Time Lapse ETA 9051 Continued Weeks Compendated Time Lapse.pdf Form and Instruction
ETA-9052 Nonmonetary Determination Time Lapse Detection Date ETA 9052 Nonmonetary Determination Time Lapse Detection Date.pdf Form
ETA-9054 Appeals Time Lapse ETA 9054 Appeals Time Lapse.pdf Form
ETA-9055 Appeals Case Aging ETA 9055 Appeals Case Aging.pdf Form and Instruction
ETA-9057 Lower Authority Appeals Quality Review ETA 9057 Lower Authority Appeals Quality Review.pdf Form and Instruction
ETA 9056 Nonmonetary Determination Quality Review ETA 9056 Nonmonetary Determination Quality Review.pdf Form and Instruction
ETA-9056 Nonmonetary Determination Quality Review proposed DCI and instructions.pdf Form and Instruction
DCI Change Justification 1 17 07.doc Nonmonetary Determination Quality Review Change Justification IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Benefits Timeliness and Quality Review System	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA-9050	First Payment Lapse Report	ETA 9050 First Payment Time Lapse Report.pdf	Yes	Yes	Fillable Printable
Form and Instruction	ETA-9051	Continued Weeks Compensated Time Lapse	ETA 9051 Continued Weeks Compendated Time Lapse.pdf	Yes	Yes	Fillable Printable
Form and Instruction	ETA-9055	Appeals Case Aging	ETA 9055 Appeals Case Aging.pdf	Yes	Yes	Fillable Printable
Form and Instruction	ETA-9057	Lower Authority Appeals Quality Review	ETA 9057 Lower Authority Appeals Quality Review.pdf	Yes	Yes	Fillable Printable
Form and Instruction	ETA 9056	Nonmonetary Determination Quality Review	ETA 9056 Nonmonetary Determination Quality Review.pdf	Yes	Yes	Fillable Printable
Form and Instruction	ETA-9056	Nonmonetary Determination Quality Review	proposed DCI and instructions.pdf	Yes	Yes	Fillable Printable
Form	ETA-9052	Nonmonetary Determination Time Lapse Detection Date	ETA 9052 Nonmonetary Determination Time Lapse Detection Date.pdf	Yes	Yes	Fillable Printable
Form	ETA-9054	Appeals Time Lapse	ETA 9054 Appeals Time Lapse.pdf	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	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	Previously Approved
Annual Number of Responses for this IC	28,912	0	28,912
Annual IC Time Burden (Hours)	37,532	-636	38,168
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Nonmonetary Determination Quality Review Change Justification	DCI Change Justification 1 17 07.doc	01/17/2007

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