OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Complaint of Employment Discrimination (Used by Permanent Employees and Applicants for Employment at DOC) and Complaint of Employment Discrimination for the Decennial Census

ICR 201001-0690-001 · OMB 0690-0015 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form CD-498 Complaint of Employment Discrimination (Used by Permanent Employees and Applicants for Employment at DOC) Form and Instruction Unchanged Available
Form CD-498A Complaint of Employment Discrimination for the Decennial Census Form and Instruction Unchanged Available
0690.0015.GINA.ChangeRequestJustiification.010710.doc Justification for No Material/Nonsubstantive Change Uploaded 2010-01-07 Available
0690.0015.SuppStmt_041508.doc Supporting Statement A Uploaded 2008-04-16 Available
DAO.215-09..doc Supplementary Document Uploaded 2008-04-10 Repair queued
ExecOrder 11478.pdf Supplementary Document Uploaded 2008-04-10 Available
IC Document Collections
IC IDCollectionTypeStatusForm
4809 Complaint of Employment Discrimination (Used by Permanent Employees and Applicants for Employment at DOC) Form and Instruction Unchanged
184426 Complaint of Employment Discrimination for the Decennial Census Form and Instruction Unchanged
ICR Details
0690-0015 201001-0690-001
Historical Active 200802-0690-002
DOC/OS
Complaint of Employment Discrimination (Used by Permanent Employees and Applicants for Employment at DOC) and Complaint of Employment Discrimination for the Decennial Census
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 01/21/2010
Retrieve Notice of Action (NOA) 01/07/2010
  Inventory as of this Action Requested Previously Approved
07/31/2011 07/31/2011 07/31/2011
700 0 700
350 0 350
0 0 0
Pursuant to the Equal Employment Opportunity Commission (EEOC) governing regulations found in 20 CFR 1614.106, someone alleging that they were subjected to discriminatory treatment by the Department of Commerce or one of its subagencies needs to submit a signed statement that is sufficiently precise to identify the general actions or practices that form the basis of the complaint. The complaint is also required to contain an address and phone number where the complainant or their representative may be contacted.
None
None
Not associated with rulemaking
  72 FR 20502 04/25/2007
73 FR 20244 04/15/2008
No
  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 700 700 0 0 0 0
Annual Time Burden (Hours) 350 350 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This is a reinstatement.
$0
No
No
Uncollected
Uncollected
No
Uncollected
Gwellnar Banks 202 482-3781 [email protected]
  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.
01/07/2010