Form ETA 9161 A,B,C ETA 9161 A,B,C Self EMployment Assistance

UI REPORTS HANDBOOK NO. 401

ETA 9161 Self Employment Assistance for UI Claimants

CONTENTS

A. Facsimile of Forms I-1-3

1. ETA 539 Screen I-1-3

2. Recommended Worksheet I-1-4

B. Purpose I-1-5

C. Due Date and Transmittal I-1-5

D. General Reporting Instructions I-1-5

1. Interstate Claims I-1-5

2. Initial Claims. I-1-6

3. Continued Weeks Claimed I-1-6

4. Adjustment of Data I-1-6

6. Checking the Report I-1-7

E. Definitions I-1-7

1. Federal-State UI Extended Compensation Program I-1-7

2. State UI Additional Compensation Program I-1-7

3. Short Time Compensation Program I-1-7

4. State UI Regular Compensation Program I-1-8

5. State Extended Benefit Period I-1-8

6. 13-Week Period I-1-8

7. Week Numbers I-1-8

8. Comparison Weeks I-1-8

9. Covered Employment I-1-9

10. Determination of State Extended Benefit Period I-1-9

F. Item by Item Instructions I-1-13

1. IC I-1-13

2. FIC I-1-13

3. XIC I-1-13

4. WSIC I-1-13

5. WSEIC I-1-13

6. CW I-1-13

7. FCW I-1-13

8. XCW I-1-13

9. WSCW I-1-13

10. WSECW I-1-13

11. EBT I-1-13

12. EBUI I-1-13

13. ABT I-1-14

14. ABUI I-1-14

15. AT I-1-14

16. CE I-1-14

17. R I-1-14

18. AR I-1-14

19. P I-1-15

20. Status I-1-15

21. Status Change Date I-1-15

22. Comments I-1-15

G. Standby Emergency Reporting I-1-16

H. Recommended Worksheet I-1-17

A. Facsimile of Forms

1. ETA 539 Screen

ETA 539 - CLAIMS AND EXTENDED BENEFITS DATA

REPORT FOR PERIOD ENDING: REGION: STATE:

Week Number: Reflected Week Ending:

IC: FIC: XIC: WSIC: WSEIC:

CW: FCW: XCW: WSCW: WSECW:

EBT: EBUI: ABT: ABUI:

AT: CE: R: AR: P:

STATUS: STATUS CHANGE DATE:

COMMENTS:

These reporting instructions have been approved under the Paperwork reduction Act of 1995, under OMB No. 1205-0028 with an expiration date of 8/31/2000. Persons are not required to respond to this collection of information unless it displays a currently valid OMB control number. Public reporting burden for this collection of information is estimated to average 50 minutes, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Submission is mandatory under SSA 303(a)(6). Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Office of Workforce Security, Room S-4231, 200 Constitution Ave., NW, Washington, DC, 20210.

2. Recommended Worksheet

RECOMMENDED WORKSHEET FOR THE TRIGGER PORTION OF THE ETA 539

-

	(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)	(9)	(10)	(11)	(12)
Wk. No.	Week End Date	Insured Unemploy-ment, Regular (CW)	Insured Unemploy. STC Equival. (WSECW)	Total Insureed Unemploy- ment (2)+(3)	13 Week Total Current (4)+ prior 12 weeks	13 Week Average (5)//13	Covered Employ- ment	Rate Current 13 Week year (6)/(7)	Rate First Prior Year	Rate Second Piror Year	Average Rate 2 Prior Years (9)+(10) 2	Percent ((8)/(11)

CONTENTS

A. Facsimile of Forms IV-X-2

B. Purpose IV-X-5

C. Due Date and Transmittal IV-X-5

D. General Reporting Instructions IV-X-5

E. Definitions IV-X-5

F. Item by Item Instructions IV-X-5

1. Facsimile of Form

ETA 9161: Self Employment Assistance (Regular Program)

STATE	REGION	REPORT FOR PERIOD ENDING
		calendar quarter end date

Section A: Claimants referred to SEA

Claimants Participating in and Receiving Benefits from SEA	C1
Benefits Paid to all SEA Claimants	C2
Claimants in SEA who Discontinue Participation	C3
Claimants in SEA who Receive a Final Payment	C4

Section B: SEA Outcomes

Number of Establishments created by SEA Claimants	C5
Cumulative Number of SEA Establishments Operating	C6
Individuals Employed by SEA Establishments	C7
Gross Revenues Earned by SEA Establishments	C8
Wages Paid to individuals by SEA Establishments	C9

Comments:

OMB No.: 1205-0490 OMB Expiration Date: 10/31/2015 Estimated Average Response Time: 2 Hours

O M B Burden Statement: These reporting instructions have been approved under the Paperwork reduction Act of 1995. Persons are not required to respond to this collection of information unless it displays a valid OMB control number. Public reporting burden for this collection of information includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Submission is required to retain or obtain benefits under SSA 303(a)(6) (42 U.S.C. 503(a)) and Pub. L. 112-96 section 2183(b)(1). Respondents have no expectation of confidentiality. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Office of Workforce Security, Room S-4526, 200 Constitution Ave., NW, Washington, DC, 20210.

ETA 9161: Self Employment Assistance (Extended Benefits Program)

STATE	REGION	REPORT FOR PERIOD ENDING
		calendar quarter end date

Section A: Claimants referred to SEA

Claimants Participating in and Receiving Benefits from SEA	C1
Benefits Paid to all SEA Claimants	C2
Claimants in SEA who Discontinue Participation	C3
Claimants in SEA who Receive a Final Payment	C4

Section B: SEA Outcomes

Number of Establishments created by SEA Claimants	C5
Cumulative Number of SEA Establishments Operating	C6
Individuals Employed by SEA Establishments	C7
Gross Revenues Earned by SEA Establishments	C8
Wages Paid to individuals by SEA Establishments	C9

Comments:

OMB No.: 1205-0490 OMB Expiration Date: 10/31/2015 Estimated Average Response Time: 2 Hours

O M B Burden Statement: These reporting instructions have been approved under the Paperwork reduction Act of 1995. Persons are not required to respond to this collection of information unless it displays a valid OMB control number. Public reporting burden for this collection of information includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Submission is required to retain or obtain benefits under SSA 303(a)(6) (42 U.S.C. 503(a)) and Pub. L. 112-96 section 2183(b)(1). Respondents have no expectation of confidentiality. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Office of Workforce Security, Room S-4526, 200 Constitution Ave., NW, Washington, DC, 20210.

B. Purpose

The ETA 9161 report is intended to provide a description of the scope of activities states engage in supporting Self Employment Assistance (SEA) for UI Claimants in the Regular and Extended Benefits Programs. It contains quarterly information on claimants who begin and exit the program.

C. Due Date and Transmittal.

The report is due in the ETA National Office on the first day of the second month following each calendar quarter to which it relates.

D. General Reporting Instructions.

This report summarizes claimant activity in the SEA program. Claimants subject to reporting include anyone who is eligible to receive a week of payment in the SEA program as administered by the state. There are program specific forms to accommodate reporting for SEA participants in the regular program and the Federal State Extended Benefits program. States should ensure that reporting activity is recorded on the correct form by program type.

States should ensure that they are able to capture the necessary outcome data from the SEA program as requested on the form. In many cases, the only effective way to accomplish this is to build into the claimant’s SEA agreement a responsibility to follow up with the state and to provide data on the continued operation of their establishment, whether it employs people and what wages these people are paid, and what sorts of revenues the establishment may be generating. States should not rely on UI wage records or state business tax records, as many self-employed individuals may not be represented in those systems and would go under-reported.

E. Definitions

Establishment: For the purposes of this report, states should use the definition of establishment provided by the Bureau of Labor Statistics for the Current Employment Statistics Survey. An establishment is an economic unit, such as a factory, mine, store, or office that produces goods or services. It generally is at a single location and is engaged predominantly in one type of economic activity. Where a single location encompasses two or more distinct activities, these are treated as separate establishments, if separate payroll records are available, and the various activities are classified under different industry codes.

F. Item by Item Instructions

1. Claimants Participating in and Receiving Benefits from SEA: Provide the number of claimants who are part of the state’s SEA program and received at least one check during the reporting period. Do not include counts of claimants who attended an orientation, or made inquiries about SEA or were referred to the program but never formally entered the program. Include counts of claimants who entered the program and received at least one payment but were subsequently disqualified for monetary or non-monetary reasons.

2. Benefits Paid to all SEA Claimants: Provide the total benefits paid during the report period to all claimants participating in the state SEA program.

3. Claimants in SEA who Discontinue Participation: Enter the number of claimants who chose to leave the SEA program, or who were removed from the program due to monetary or non-monetary eligibility issues.

4. Claimants in SEA who Receive a Final Payment: enter the number of claimants who entered the state SEA program and received a payment that reduced their account balance to zero in the program in which they are claiming benefits.

5. Number of Establishments created by SEA Claimants: Enter the number of establishments created by SEA claimants.

6. Number of SEA Establishments Operating: Report the number of establishments that were created by claimants in the SEA program in prior reporting periods that continue to operate during the current reporting period.

7. Individuals Employed by SEA Establishments: Report the number of people employed by SEA establishments identified in items 5 and 6 above. Including the SEA participant in the total reported.

8. Gross Revenues Earned by SEA Establishments: Report the gross revenues earned by SEA Establishments identified in items 5 and 6 above.

9. Wages Paid by SEA Establishments: Report the amount of wages and compensation paid to individuals, including the SEA participant, reported as employed by SEA establishments identified in items 5 and 6 above.

IV-X-5

09/2015