PAPERWORK REDUCTION ACT SUBMISSION
Please read the instructions before completing this form. For additional forms or assistance in completing this form, contact your agency's Paperwork Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting Statement, and any additional documentation to: Office of Information and Regulatory Affairs, Office of Management and Budget, Docket Library, Room 10102, 725 17th Street NW, Washington, DC 20503.
1. Agency/Subagency originating request: 2. OMB control number: b. None Department of Labor, Employment and Training Administration a. 1 2 0 5 -- 0 3 5 2
3. Type of information collection (check one) 4. Type of review requested (check one) a. New collection a. X Regular b. Revision of a currently approved collection b. Emergency--Approval requested by: / / c. X Extension of a currently approved collection c. Delegated d. Reinstatement, without change, of a previously approved collection for which approval has expired 5. Small entities e. Reinstatement, with change, of a previously approved Will this information collection have a significant economic impact collection for which approval has expired on a substantial number of small entities? Yes X No f. Existing collection in use without an OMB control number 6. Requested expiration date For b.- f., note item A2 of Supporting Statement instructions a. X Three years from approval date b. Other--Specify: / /
7. Title Attestation by Employers Using Crewmembers for Longshore Activities at Locations in the State of Alaska
8. Agency form number(s) (if applicable) ETA 9033-A
9. Keywords Immigrants, Aliens, Ports
10. Abstract The application form and other requirements in these regulations for employers seeking to use H-1B nonimmigrants in specialty occupations and as fashion models will permit the Department to meet its statutory responsibilities for program administration, management, and oversight.
11. Affected public (mark primary with "P" and all others that apply 12. Obligation to respond (mark primary with "P" and all others that with "X") apply with "X") a. Individuals or households d. Farms a. Voluntary b. P Business or other for-profit e. _ Federal Government b. P Required to obtain or retain benefits c. __ Not-for-profit institutions f. _ State, Local, or Tribal govt. c. XMandatory
13. Annual reporting and recordkeeping hour burden 14. Annual reporting and recordkeeping cost burden (in thousands of a. Number of respondents ___ 100___ dollars) b. Total annual responses ____ 100___ a. Total annualized capital/startup costs ______0______1. Percentage of those responses b. Total annual costs (O&M) ______0______c. collected electronically ___0.0%_____ c. Total annualized cost requested ______0______Total annual hours requested ___ 300____ d. Current OMB inventory ______0______d. Current OMB inventory ___ 1,050 ___ e. e. Difference ______0______f. Difference ____ 750_____ Explanation of difference ______0______f. Explanation of difference ______1. Program change ______0______1. Program change ___ 0______2. Adjustment ______0______2. Adjustment _____750____
15. Purpose of information collection (mark primary with "P" and all 16. Frequency of recordkeeping or reporting (check all that apply) others that apply with "X") a. X Recordkeeping b. Third party disclosure a. _ Application for benefits e. __ Program planning or c. Reporting b. Program evaluation management 1. X On occasion 2. Weekly 3. Monthly c. General purpose statistics f. Research 4. Quarterly 5. Semi-annually 6. Annually d. Audit g. P Regulatory or compliance 7. Biennially 8. Other (describe)
17. Statistical methods 18. Agency contact (person who can best answer questions regarding Does this information collection employ statistical methods? the content of the submission) Yes X No Name: Greg Wilson Phone: (202) 693-2954
OMB 83-I 10/95 19. Certification for Paperwork Reduction Act Submissions On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9.
NOTE: The text of 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3), appear at the end of the instructions. The certification is to be made with reference to those regulatory provisions as set forth in the instructions.
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 terminology 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);
(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 (see note in Item 19 of the instructions);
(i) It uses effective and efficient statistical survey methodology; and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item below and explain the reason in Item 18 of the Supporting Statement.
Signature of Senior Official or designee Date
Signature of Agency Official Date
OMB 83-I 10/95 Instructions for Completing OMB c. Check AExtension@ when the collection under the conditions collection is currently approved OMB has granted the agency Please answer all questions and have the by OMB, and the agency delegated authority. Senior Official or designee sign the wishes only to extend the form. These instructions should be used approval past the current 5. Small entities in conjunction with 5 CFR 1320, which expiration date without making provides information on coverage, any material change in the Indicate whether this information definitions, and other matters of collection instrument, collection will have a significant procedure and interpretation under the instructions, frequency of impact on a substantial number of Paperwork Reduction Act of 1995. collection, or the use to which small entities. A small entity may the information is to be put. be (1) a small business which is 1. Agency/Subagency originating deemed to be one that is request d. Check AReinstatement without independently owned and operated change@ when the collection and that is not dominant in its field Provide the name of the agency or previously approved had OMB of operation; (2) a small subagency originating the request. approval, but the approval has organization that is any not-for- For most cabinet-level agencies, a expired or was withdrawn profit enterprise that is subagency designation is also before this submission was independently owned and operated necessary. For non-cabinet made, and there is no change and is not dominant in its field; or agencies, the subagency designation the collection. (3) a small government jurisdiction is generally unnecessary. which is a government of a city, e. Check AReinstatement with county, town, township, school OMB control number change@ when the collection district, or special district with a previously has OMB approval, population of less than 50,000. a. If the information collection in but the approval has expired or this request has previously was withdrawn before this 6. Requested expiration date received or now has an OMB submission was made, and there control or comment number, is change to the collection. a. Check AThree years@ if the enter the number. agency requests a three year f. Check AExisting collection in approval for the collection. b. Check ANone@ if the use without OMB control information collection in this number@ when the collection is b0 Check AOther@ if the agency request has not previously currently in use but does not requests approval for less than received an OMB control have a currently valid OMB three years. Specify the month number. Enter the four digit control number. and year of the requested agency code for your agency. expiration date. 4. Type of review requested 3. Type of information collection (check one) 7. Title (check one) a. Check ARegular@ when the Provide the official title of the a. Check New collection when A @ collection is submitted under 5 information collection. If an official the collection has not CFR 1320.10, 1320.11, or title does not exist, provide a previously been used or 1320.12 with a standard 60 day description which will distinguish sponsored by an agency. review schedule. this collection from others. b. Check Revision when the 8. Agency form number(s) (if A @ b. Check AEmergency@ when the applicable) collection is currently approved agency is submitting the request by OMB, and the agency under 5 CFR 1320.13 for Provide any form number the request includes a material emergency processing and agency has assigned to this change to the collection provides the required collection of information. Separate instrument, instructions, its supporting material. Provide each form number with a comma. frequency of collection, or the the date by which the agency use to which the information is requests approval. to be put. 9. Keywords c. Check ADelegated@ when the agency is submitting the Select and list at least two keywords area(s) of the information collection. with commas. Keywords should not (description) from the AFederal Other terms may be used but should exceed two lines of text. Register Thesaurus of Indexing be listed after those selected from Terms@ that describe the subject the thesaurus. Separate keywords 10. Abstract using magnetic media (i.e., b0 Enter recurring annual dollar Provide a statement, limited to five diskette), electronic mail, or amount of cost for all lines of text, covering the agency=s electronic data interaction. respondents associated with need for the information, uses to Facsimile is not considered an operating or maintaining which it will be put, and a brief electronic submission. systems or purchasing services. description of the respondents. c0 Enter the total annual c0 Enter total (14a + 14b) annual 11. Affected public recordkeeping and reporting reporting and recordkeeping hour burden. cost burden. Mark all categories that apply, denoting the primary public with a d0 Enter the burden hours d0 Enter any cost burden currently AP@ and all others that apply with currently approved by OMB for approved by OMB for this AX.@ this collection of information. collection of information. Enter Enter zero (0) for any new zero (0) if this is the first 12.Obligation to respond submission or for any collection submission after October 1, whose OMB approval has 1995. Mark all categories that apply, expired. denoting the primary obligation with e0 Enter the difference by a AP@ and all others that apply with e0 Enter the difference by subtracting line d from line c. AX@. subtracting line d from line c. Record a negative number (d Record a negative number (d larger than c) within a0 Mark AVoluntary@ when the larger than c) within parenthesis. response is entirely parenthesis. discretionary and has not direct f0 Explain the difference. The effect on any benefit or f0 Explain the difference. The difference in line e must be privilege for the respondent. difference in line e must be accounted for in line f1 and f2. accounted for in lines f1 and f2. f1. Program change is the result b0 Mark ARequired to obtain or A @ f1. AProgram change@ is the result of deliberate Federal government retain benefits@ when the of deliberate Federal government action. All new collections and any response is elective, but is action. All new collections and any subsequent revisions or changes required to obtain or retain a subsequent revision of existing resulting in cost changes are benefit. collections (e.g. the addition or recorded as program changes. deletion questions) are recorded as c0 Mark AMandatory@ when the program changes. f2. AAdjustment@ is a change that respondent must reply or face is not the result of a deliberate civil or criminal sanctions. f2. AAdjustment@ is a change that Federal government action. is not the result of a deliberate Changes resulting from new 13. Annual reporting and Federal government action. estimations or actions not recordkeeping hour burden Changes resulting from new controllable by the Federal estimates or actions not controlled government are recorded as a0 Enter the number of by the Federal government are adjustments. respondents and/or recorded as adjustments. recordkeepers. If a respondent 15. Purpose of information collection is also a recordkeeper, report 14. Annual reporting and the respondent only once. recordkeeping cost burden (in Mark all categories that apply, thousands of dollars) denoting the primary purpose with a b0 Enter the number of responses P and all others that apply with provided annually. For A @ The cost identified in this item must recordkeeping as compared to AX@. exclude the cost of hour burden reporting activity, the number identified in Item 13. of responses equals the number a0 Mark AApplication for of recordkeepers. benefits@ when the purpose is a0 Enter total dollar amount of to participate in, receive, or annualized cost for all b1. Enter the estimated percentage qualify for a grant, financial respondents of any associated of responses that will be assistance, etc., from a Federal capital or start-up costs. submitted/collected electronically agency or program.
b0 Mark AProgram evaluation@ measures and systematic programs achieve their when the purpose is a formal analysis, of the manner and objectives or produce other assessment, through objective extent to which the Federal significant effects. is to measure compliance with evaluations. For other types of data c0 Mark AGeneral purpose laws or regulations. collection, the use of sampling, statistics@ when the data is imputation, or other statistical collected chiefly for use by the 1 16.Frequency of recordkeeping or estimation techniques should dictate public or for general reporting the response for this item. Ensure government use, without that supporting documentation is primary reference to the policy Check ARecordkeeping@ if the provided in accordance with Section or program operations of the collection of information explicitly B of the Supporting Statement. agency collecting the data. includes a recordkeeping requirement. 18. Agency contact d0 Mark AAudit@ when the Check @Third party disclosure@ if a purpose is to verify the collection of information includes Provide the name and telephone accuracy of accounts and third-party disclosure requirements number of the agency person best records. as defined by 1320.3 (c). able to answer questions regarding Check AReporting@ for information the content of this submission. e0 Mark AProgram planning and collections that involve reporting management@ when the and check the frequency of reporting 19. Certificate of Paperwork purpose relates to progress that is requested or required of a Reduction Act Submission reporting and grants respondent. If the reporting is on management, procurement and Aan event basis", check AOn The Senior Official or designee quality control or other occasion@. signing this statement certifies that administrative information that the collection of information does not fit into any other 17. Statistical methods encompassed by the request category. complies with f5 CFR 1320.9. Check AYes@ if the information Provisions of this certification that f0 Mark AResearch@ when the collection uses statistical methods the agency cannot comply with purpose is to further the course such as sampling or imputation. should be identified and fully explained in item 18 of the attached of research, rather than for a Generally, check "No@ for Supporting Statement. NOTE: The specific program purpose. applications and audits (unless a Office that develops and uses random auditing scheme is used). A @ A @ the information to be collected is the g0 Mark ARegulatory or Check AYes@ for statistical office that conducts or sponsors compliance@ when the purpose collections, most research A @ collections, and scientific program the collection of information (See 5 CFR 1320.3(d).