Information Collection

Waivers of Rights and Claims Under the ADEA; Informational Requirements

IC 29381 under ICR 201608-3046-001 · OMB 3046-0042.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3046-0042 can be found here:

Documents and Forms

Document Name Document Type
2016 60 Day ADEA PRA Notice.pdf 60 Day PRA ADEA Notice IC Document
Published 30 Day FR Notice- ADEA PRA Waiver.pdf 30 Day PRA ADEA Notice IC Document
[2.07.17 Revised] Supporting Statement for 2016 PRA ADEA Waiver.docx EEOC Supporting Statement IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Waivers of Rights and Claims Under the ADEA; Informational Requirements	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 1625.22

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Litigation and Judicial Activities

Subfunction: Legal Investigation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 127	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	127	-17,223	270	17,080
Annual IC Time Burden (Hours)	2,090	-23,935	405	25,620
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
60 Day PRA ADEA Notice	2016 60 Day ADEA PRA Notice.pdf	08/16/2016
30 Day PRA ADEA Notice	Published 30 Day FR Notice- ADEA PRA Waiver.pdf	08/22/2016
EEOC Supporting Statement	[2.07.17 Revised] Supporting Statement for 2016 PRA ADEA Waiver.docx	02/07/2017

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