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Federal forms, ICRs, and supporting documents

Information Collection Request

RECEIPT FOR PAYMENT OF BACKPAY, DAMAGES OR OTHER MONETARY BENEFITS (EQUAL PAY ACT)

ICR 197909-3046-001 · OMB 3046-0020 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
149334 RECEIPT FOR PAYMENT OF BACKPAY, DAMAGES OR OTHER MONETARY BENEFITS (EQUAL PAY ACT) Form Migrated
ICR Details
3046-0020 197909-3046-001
Historical Active
EEOC
RECEIPT FOR PAYMENT OF BACKPAY, DAMAGES OR OTHER MONETARY BENEFITS (EQUAL PAY ACT)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 10/22/1979
Retrieve Notice of Action (NOA) 09/14/1979
  Inventory as of this Action Requested Previously Approved
10/31/1981 10/31/1981
20,000 0 0
1,666 0 0
0 0 0
THE FORM IS USED TO VERIFY THAT EMPLOYEES WHO ARE DUE BACK WAGES UNDER THE EQUAL PAY ACT AND AGE DISCRIMINATION IN EMPLOYMENT ENFORCED BY EEOC HAVE RECEIVED AN ACCEPTED PAYMENT. THE REQUEST FOR INFORMATION IS MADE OF THOSE EMPLOYERS FOUND BY EEOC TO BE IN VIOLATION OF THE EPA AND/OR ADEA AND IN RECOGNITION OF AN EMPLOYER'S OBLIGATION TO VOLUNTARILY CORRECT ANY AND ALL VIOLATIONS OF THE ACTS
None
None
No
1
IC Title Form No. Form Name
RECEIPT FOR PAYMENT OF BACKPAY, DAMAGES OR OTHER MONETARY BENEFITS (EQUAL PAY ACT) EEOC 379
  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 20,000 0 0 0 20,000 0
Annual Time Burden (Hours) 1,666 0 0 0 1,666 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/14/1979