Information Collection

OFCCP Complaint Form

IC 13803 under ICR 201003-1250-002 · OMB 1250-0002.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1250-0002 can be found here:

Documents and Forms

Document Name Document Type
Form CC-4 OFCCP Complaint Form Form and Instruction
CC-4 Complaint of Discrimination in Employment Under Federal NewCC-4Wchgs-09-25-07.pdf Form and Instruction
CC-4 OFCCP Complaint Form CC-4ComplaintForm-06-13-07.pdf www.dol.gov/esa/regs/compliance/ofccp/pdf/pdfstart.htm Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	OFCCP Complaint Form	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 41 CFR 60-1.23(a) 41 CFR 60-250.61(b) 41 CFR 60-741.61(c) (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CC-4	Complaint of Discrimination in Employment Under Federal Government Contracts	NewCC-4Wchgs-09-25-07.pdf		Yes	Yes	Fillable Printable
Form and Instruction	CC-4	OFCCP Complaint Form	CC-4ComplaintForm-06-13-07.pdf	http://www.dol.gov/esa/regs/compliance/ofccp/pdf/pdfstart.htm	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title: OFCCP Complaint Form	FR Citation: 5 FR 552

Number of Respondents: 594	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 19 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	594	-254	848
Annual IC Time Burden (Hours)	760	-325	1,085
Annual IC Cost Burden (Dollars)	261	261	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.