Information Collection

Elementary-Secondary Staff Information (EEO-5)

IC 29363 under ICR 200806-3046-003 · OMB 3046-0003.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3046-0003 can be found here:

Documents and Forms

Document Name Document Type
Form EEOC-168A Elementary-Secondary Staff Information (EEO-5) Form
EEOC-168A EEO-5 eeo5form.pdf www.eeoc.gov Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Elementary-Secondary Staff Information (EEO-5)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	EEOC-168A	EEO-5	eeo5form.pdf	www.eeoc.gov	Yes	Yes	Fillable Fileable

Line of Business: Litigation and Judicial Activities

Subfunction: Legal Investigation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7,500	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	7,500	2,500	5,000
Annual IC Time Burden (Hours)	10,000	0	10,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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