Information Collection Request
DHS Civil Rights Compliance Form
ICR 202301-1601-001 · OMB 1601-0024 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1601-0024 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form DHS Form 3095 DHS Civil Rights Compliance Form 3095 |
Form and Instruction | Modified | Available |
 OMB Form 83-C for DHS Form 3095.pdf |
Justification for No Material/Nonsubstantive Change | Uploaded 2023-01-11 | Available |
 1601-0024_Supporting Statement A for Renewal DHS Form 3095.docx |
Supporting Statement A | Uploaded 2023-01-11 | Available |
| Narrative of Changes Table - DHS Civil Rights Evaluation Tool Updated 2.16.2021.docx |
Supplementary Document | Uploaded 2023-01-11 | Available |
| 42 USC 6101.pdf |
Supplementary Document | Uploaded 2016-11-28 | Available |
| 42 USC 2000d-1.pdf |
Supplementary Document | Uploaded 2016-11-28 | Available |
| 29 USC 794.pdf |
Supplementary Document | Uploaded 2016-11-28 | Available |
| 28 CFR Part 42.docx |
Supplementary Document | Uploaded 2016-11-28 | Available |
| 20 USC 1681.pdf |
Supplementary Document | Uploaded 2016-11-28 | Available |
| 44 CFR Part 19.pdf |
Supplementary Document | Uploaded 2016-11-28 | Available |
| 44 CFR Part 7.pdf |
Supplementary Document | Uploaded 2016-11-28 | Available |
| 6 CFR Part 21.pdf |
Supplementary Document | Uploaded 2016-11-28 | Available |
| 6 CFR Part 17.pdf |
Supplementary Document | Uploaded 2016-11-28 | Available |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 224608 |  DHS Civil Rights Compliance Form 3095 |
Form and Instruction | Modified |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | DHS/OS |
| OMB Control No | 1601-0024 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202103-1601-002 |
| Date Submitted to OIRA | 2023-01-11 |
| Requested Expiration Date | 1969-12-31 |