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⚠️ Notice: This information collection may be referencing outdated material.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 Time Lapse SectionV_Benefits_TimeLapse_and_Quality_ETA 9050_Change_1.doc Form and Instruction
ETA-9051 Continued Weeks Compensated Time Lapse SectionV_Benefits_TimeLapse_and_Quality_ETA 9051.doc Form and Instruction
ETA 9052 Nonmonetary Determination TIme Lapse Detection SectionV_Benefits_TimeLapse_and_Quality_ETA 9052.doc Form and Instruction
ETA 9054 Appeals Time Lapse SectionV_Benefits_TimeLapse_and_Quality_ETA 9054.doc Form and Instruction
ETA 9055 Appeals Case Aging SectionV_Benefits_TimeLapse_and_Quality_ETA 9055.doc Form and Instruction
ETA 9056 Nonmonetary Determination Quality Review SectionV_Benefits_TimeLapse_and_Quality_ETA 9056.doc Form and Instruction
ETA 9057 Lower Authority Appeals Quality Review SectionV_Benefits_TimeLapse_and_Quality_ETA 9057.doc Form and Instruction

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: Required to Obtain or Retain Benefits

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 Time Lapse	SectionV_Benefits_TimeLapse_and_Quality_ETA 9050_Change_1.doc	Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9051	Continued Weeks Compensated Time Lapse	SectionV_Benefits_TimeLapse_and_Quality_ETA 9051.doc	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9052	Nonmonetary Determination TIme Lapse Detection	SectionV_Benefits_TimeLapse_and_Quality_ETA 9052.doc	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9054	Appeals Time Lapse	SectionV_Benefits_TimeLapse_and_Quality_ETA 9054.doc	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9055	Appeals Case Aging	SectionV_Benefits_TimeLapse_and_Quality_ETA 9055.doc	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9056	Nonmonetary Determination Quality Review	SectionV_Benefits_TimeLapse_and_Quality_ETA 9056.doc	Yes	Yes	Fillable Fileable
Form and Instruction	ETA 9057	Lower Authority Appeals Quality Review	SectionV_Benefits_TimeLapse_and_Quality_ETA 9057.doc	Yes	Yes	Fillable Fileable

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	29,976	1,064	28,912
Annual IC Time Burden (Hours)	39,892	2,360	37,532
Annual IC Cost Burden (Dollars)	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.