Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor

ICR 201609-1250-001 · OMB 1250-0002 · Historical Active

⚠️ Notice: This information collection may be outdated.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

Forms and Documents

Document	Type	Status	Availability
1250-0002 Supporting Statement.docx	Supporting Statement A	Uploaded 2016-11-01	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
13803	Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor	Instruction	Modified

ICR Details

OMB Control No: 1250-0002	ICR Reference No: 201609-1250-001
Status: Historical Active	Previous ICR Reference No: 201409-1250-007
Agency/Subagency: DOL/OFCCP	Agency Tracking No:
Title: Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/24/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/21/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2020	36 Months From Approved	08/31/2017
Responses	753	0	747
Time Burden (Hours)	753	0	747
Cost Burden (Dollars)	62	0	52

Abstract: The complaint form is prepared by individuals who allege employment discrimination by Federal contractors under any of the three laws enforced by OFCCP. OFCCP is requesting approval of the complaint form that has been updated to reflect changes to OFCCP's legal authorities.

Authorizing Statute(s): US Code: 38 USC 4212 Name of Law: Vietnam Era Veterans' Readjustment Assistance Act of 1974
   EO: EO 11246 Name/Subject of EO: Equal Employment Opportunity
   US Code: 29 USC 793 Name of Law: Rehabilitation Act of 1973

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 43254	07/01/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 11245	02/21/2017
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor	CC-4	Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	753	747	6
Annual Time Burden (Hours)	753	747	6
Annual Cost Burden (Dollars)	62	52	10

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The minimal increase in burden occurred because OFCCP, on average over the past three years, received 6 more complaints than estimated in the prior approved ICR package. The cost of stamps and envelopes also went up slightly.

Annual Cost to Federal Government: $59,645

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Christopher Seely 202 693-1180 [email protected]

Common Form ICR: No