OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Complaint of Discrimination Under Section 504, Section 508 or Title VI

ICR 201512-1405-002 · OMB 1405-0220 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
Form DS4282 Discrimination Complaint Form Form and Instruction Modified Available
1405-0220 DS-4282 Supporting Statement 2-24.docx Supporting Statement A Uploaded 2016-02-24 Available
Legal Authorities (7-29-15).docx Supplementary Document Uploaded 2015-07-30 Available
IC Document Collections
IC IDCollectionTypeStatusForm
217700 Discrimination Complaint Form Form and Instruction Modified
ICR Details
1405-0220 201512-1405-002
Historical Inactive 201507-1405-005
STATE/AFA
Complaint of Discrimination Under Section 504, Section 508 or Title VI
New collection (Request for a new OMB Control Number)   No
Regular
Comment filed on proposed rule 02/24/2016
Retrieve Notice of Action (NOA) 12/08/2015
State must submit an information collection request prior to issuing a final rule.
  Inventory as of this Action Requested Previously Approved
36 Months From Approved
0 0 0
0 0 0
0 0 0
The DS-4282 will be used to submit complaints of discrimination under Title VI of the Civil Rights Act of 1964; and Sections 504 and 508 of the Rehabilitation Act of 1973.
US Code: 42 USC 2000 Name of Law: Title VI of the Civil Rights Act of 1964
   US Code: 29 USC 794 Name of Law: Rehabilitation Act of 1973
  
None
1400-AD87 Proposed rulemaking 81 FR 44 01/04/2016
No
1
IC Title Form No. Form Name
Discrimination Complaint Form DS4282 Discrimination Complaint Form
Yes
Changing Regulations
No
This is a new information collection.
$1,602
No
No
No
No
No
Uncollected
Alice Kottmyer 202 647-2318 [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.
12/08/2015