Information Collection

NRC Form 655, "EEO Counselor's Report"

IC 253909 under ICR 202205-3150-002 · OMB 3150-0256.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3150-0256 can be found here:

Documents and Forms

Document Name Document Type
Form NRC Form 655 NRC Form 655, "EEO Counselor's Report" Form and Instruction
NRC Form 655 EEO Counselor's Report NRC 655 (OMB Copy).pdf Form and Instruction
NRC Form 655 EEO Counselor's Report NRC 655 revised 12-15-22.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NRC Form 655, "EEO Counselor's Report"	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NRC Form 655	EEO Counselor's Report	NRC 655 revised 12-15-22.pdf		Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title: EEOC/GOVT-1 Equal Employment Opportunity in the Federal Government Complaint and Appeal Records	FR Citation: 71 FR 24704

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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