The information will be used by SSA to
investigate and informally resolve complaints of discrimination
based on race, color, national origin, sex, age, religion, and
retaliation in any program or activity conducted by SSA. The
information will be used to identify the complainant; identify the
alleged discriminatory act; ascertain the date of such alleged act;
obtain the identify of the identify of the individual(s)/
facility/component that allegedly discrimanted; and ascertain other
relevant information that would assist in the investigation and
resolution of the complaints.
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.