Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor

ICR 201910-1250-003 · OMB 1250-0002 · 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⚠️ Notice: This information collection may be outdated.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
ICR_ComplaintForm_30-DaySupportingStatement_20200306 FINAL.docx	Supporting Statement A	Uploaded 2020-03-06	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: 201910-1250-003
Status: Active	Previous ICR Reference No: 201609-1250-001
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: 05/29/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/15/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2023	36 Months From Approved	05/31/2020
Responses	897	0	753
Time Burden (Hours)	897	0	753
Cost Burden (Dollars)	169	0	62

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

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:
	84 FR 56205	10/21/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 19960	04/09/2020
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	897	753	144
Annual Time Burden (Hours)	897	753	144
Annual Cost Burden (Dollars)	169	62	107

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: OFCCP is requesting OMB approval of 897 burden hours and $169 in costs. This is an increase in burden from the previous approval of 753 hours and $61.50 in costs. This is due to an increase in respondent universe, based on agency estimate of complaints received in the past three years.

Annual Cost to Federal Government: $93,288

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

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? No

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

Common Form ICR: No