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 202011-0690-001 · OMB 0690-0015 · Received in OIRA

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 Repair queued
Form CD-498A Complaint of Employment Discrimination for the Decennial Census Form and Instruction Modified Missing upstream
Supporting Statement Part A CD-498 revised December 2020 vs 2.docx Supporting Statement A Uploaded 2020-12-21 Repair queued
DAO 215-9.docx Supplementary Document Uploaded 2017-10-18 Repair queued
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 202011-0690-001
Received in OIRA 201710-0690-002
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 12/22/2020
  Requested Previously Approved
36 Months From Approved 01/31/2021
600 700
300 350
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
  85 FR 61923 10/01/2020
85 FR 83513 12/22/2020
Yes
  Total Request 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 600 700 0 0 -100 0
Annual Time Burden (Hours) 300 350 0 0 -50 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$225,500
No
    Yes
    Yes
No
No
No
No
Paul Redpath 202 482-2627
  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.
12/22/2020