CHARGE OF DISCRIMINATION

ICR 197808-3046-014

OMB: 3046-0011

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
149309 Migrated
ICR Details
3046-0011 197808-3046-014
Historical Active
EEOC
CHARGE OF DISCRIMINATION
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 08/16/1978
Retrieve Notice of Action (NOA) 08/16/1978
  Inventory as of this Action Requested Previously Approved
01/31/1981 01/31/1981
45,000 0 0
112,500 0 0
0 0 0

(RESPONDENT IS LOCATED IN A NON-DEFERRAL JUSTIDICTION.) THE PURPOSE OF THE FORM IS TO ASSIST PERSONS WHO BELIEVE THEY HAVE BEEN AGGRIEVED TO FILE CHARGES OF UNLAWFUL EMPLOYMENT PRACTICES WITH THE COMMISSION. THE DATA IS USED BY EEOC IN ITS INVESTIGATION OF ALLEGATIONS MADE BY THE INDIVIDUAL FILING THE CHARGE. SECTION 706(B) OF TITLE VII OF THE CIVIL RIGHTS ACT OF 1964, AS AMENDED, REQUIRES THAT CHARGES BY IN WRITING UNDER OATH OR AFFIMATION

None
None


No

1
IC Title Form No. Form Name
CHARGE OF DISCRIMINATION EEOC-5A

  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 45,000 0 0 0 45,000 0
Annual Time Burden (Hours) 112,500 0 0 0 112,500 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
08/16/1978


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