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 and Complaint of Employment Discrimination for the Decennial Census

ICR 201710-0690-002 · OMB 0690-0015 · 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 Available
Form CD-498A Complaint of Employment Discrimination for the Decennial Census Form and Instruction Modified Repair queued
0690-0015 SuppStmt 2017.doc Supporting Statement A Uploaded 2017-10-27 Available
DAO 215-9.docx Supplementary Document Uploaded 2017-10-18 Available
Executive Order 11478.docx Supplementary Document Uploaded 2017-10-18 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
4809 Complaint of Employment Discrimination (Used by Permanent Employees and Applicants for Employment at DOC) Form and Instruction Modified
212587 Complaint of Employment Discrimination for the Decennial Census Form and Instruction Modified
ICR Details
0690-0015 201710-0690-002
Active 201407-0690-003
DOC/OS
Reporting Process for Complaint of Employment Discrimination Used by Permanent Employees and Applicants for Employment at DOC and Complaint of Employment Discrimination for the Decennial Census
Extension without change of a currently approved collection   No
Regular
Approved without change 12/04/2017
Retrieve Notice of Action (NOA) 10/27/2017
  Inventory as of this Action Requested Previously Approved
12/31/2020 36 Months From Approved 12/31/2017
700 0 700
350 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
  82 FR 40134 08/24/2017
82 FR 49784 10/27/2017
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 700 700 0 0 0 0
Annual Time Burden (Hours) 350 350 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$225,500
No
    Yes
    Yes
No
No
No
Uncollected
Kathy Anderson 202 482-3860 [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.
10/27/2017