OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Reporting Process for Complaint of Employment Discrimination used by Permanent Employees and Applicants for Employment at DOC

ICR 201106-0690-002 · 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 Modified Repair queued
Form CD-498A Complaint of Employment Discrimination for the Decennial Census Form and Instruction Removed Available
0690 0015 Employ. Discrim.SuppStmt REVISED 081111 (2).docx Supporting Statement A Uploaded 2011-08-19 Available
DAO.215-09..doc Supplementary Document Uploaded 2008-04-10 Available
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 Modified
184426 Complaint of Employment Discrimination for the Decennial Census Form and Instruction Removed
ICR Details
0690-0015 201106-0690-002
Historical Active 201001-0690-001
DOC/OS
Reporting Process for Complaint of Employment Discrimination used by Permanent Employees and Applicants for Employment at DOC
Revision of a currently approved collection   No
Regular
Approved with change 09/26/2011
Retrieve Notice of Action (NOA) 07/25/2011
Updated supporting statement.
  Inventory as of this Action Requested Previously Approved
09/30/2014 36 Months From Approved 09/30/2011
300 0 700
150 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
  76 FR 13977 03/15/2011
76 FR 44303 07/25/2011
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 300 700 0 -400 0 0
Annual Time Burden (Hours) 150 350 0 -200 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
The program change decreases (400 respondents/responses and 200 burden hours) are due to the removal of the decennial census form used to report complaints by temporary employees.
$545,000
No
No
No
No
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.
07/25/2011