OFCCP Complaint Form

ICR 200410-1215-002

OMB: 1215-0131

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
13803 Migrated
ICR Details
1215-0131 200410-1215-002
Historical Active 200109-1215-002
DOL/ESA
OFCCP Complaint Form
Revision of a currently approved collection   No
Regular
Approved without change 01/03/2005
Retrieve Notice of Action (NOA) 10/29/2004
Approved. Recommend ESA investigate and implement increasing the percent of respondents submitting electronically and report back to OMB upon next submission.
  Inventory as of this Action Requested Previously Approved
01/31/2008 01/31/2008 12/31/2004
848 0 1,046
1,085 0 1,339
0 0 0

The complaint form is prepared by individuals who allege illegal discrimination by Federal contractors under any of the three programs administered by OFCCP.

None
None


No

1
IC Title Form No. Form Name
OFCCP Complaint Form CC-4

  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 848 1,046 0 0 -198 0
Annual Time Burden (Hours) 1,085 1,339 0 0 -254 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.
10/29/2004


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