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Information Collection

Receipt For Backpay, Damages, Or Other Monetary Benefits

IC 149335 under ICR 198110-3046-001 · OMB 3046-0020.

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Information Collection (IC) Details

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RECEIPT FOR BACKPAY, DAMAGES, OR OTHER MONETARY BENEFITS
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form EEOC 379 No No


    

20,000 0
   
State, Local, and Tribal Governments
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 20,000 0 0 0 0 20,000
Annual IC Time Burden (Hours) 1,666 0 0 0 0 1,666
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
 
 
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.