Job Corps Application Data

Forms and Documents

Document Name	Status
Form ETA 652 Job Corps Applicant Data Sheet Form and Instruction	Modified
Form ETA 652 Job Corps Application Data Form and Instruction	Modified
EO_14168_Non Substantiative_1205-0025_JC Applicant Data Collection.docx Justification for No Material/Nonsubstantive Change	2025-03-13
1205-0025 Supporting Statement 022223 clean.docx Supporting Statement A	2023-02-22

IC Document Collections

IC ID	Document Title	Status
258627	Verbal Verification of Dependents	Unchanged
258574	Verbal Verification of Childcare	Unchanged
12941	Job Corps Application Data Form and Instruction	Modified	Job Corps Applicant Data Sheet
12941	Job Corps Application Data Form and Instruction	Modified

ICR Details

OMB Control No: 1205-0025	ICR Reference No: 202503-1205-007
Status: Active	Previous ICR Reference No: 202212-1205-008
Agency/Subagency: DOL/ETA	Agency Tracking No:
Title: Job Corps Application Data
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/23/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/09/2025
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2026	04/30/2026	04/30/2026
Responses	139,948	0	139,948
Time Burden (Hours)	11,421	0	11,421
Cost Burden (Dollars)	0	0	0

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Abstract: ETA 652, Job Corps Applicant Data Sheet, is critical to the screening process. This form is completed by the admissions representative in collaboration with each applicant to determine the applicant’s eligibility for the Job Corps program in accordance with WIOA and Job Corps policy and to collect socio-demographic and employment barriers information for program planning, evaluation, and data reporting purposes. This ICR also contains verbal questions on dependents and childcare.

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Authorizing Statute(s): US Code: 29 USC 3194-3195 Name of Law: Workforce Innovation and Opportunity Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 31912	05/25/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 12698	02/28/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Job Corps Application Data	ETA 652	Job Corps Applicant Data Sheet
Verbal Verification of Childcare
Verbal Verification of Dependents

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ICR Summary of Burden

	Total Approved	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	139,948	139,948	0	0	0	0
Annual Time Burden (Hours)	11,421	11,421	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $543,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 04/09/2025

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