Information Collection

(a) Complaint of Possible Prohibited Personnel Practice or Other Prohibited Activity, (b) Disclosure of Information

IC 35835 under ICR 200611-3255-001 · OMB 3255-0002.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3255-0002 can be found here:

Documents and Forms

Document Name Document Type
Form OSC Form 13 (a) Complaint of Possible Prohibited Personnel Practice or Other Prohibited Activity, (b) Disclosure of Information Form and Instruction
OSC-11 Complaint of Possible Prohibited Personnel Practice osc11.pdf www.osc.gov/forms.htm Form
OSC-12 Information About Filing a Whistleblower Disclosure with osc12.date fixed.pdf www.osc.gov/forms.htm Form
OSC Form 13 Complaint of Possible Prohibited Political Activity (Vio osc13.pdf www.osc.gov/forms.htm Form and Instruction
OSC Form 14 Complaint of Possible Violation of USERRA osc14.pdf www.osc.gov/forms.htm Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	(a) Complaint of Possible Prohibited Personnel Practice or Other Prohibited Activity, (b) Disclosure of Information	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	OSC Form 13	Complaint of Possible Prohibited Political Activity (Violation of the Hatch Act)	osc13.pdf	http://www.osc.gov/forms.htm	Yes	No	Printable Only
Form	OSC-11	Complaint of Possible Prohibited Personnel Practice	osc11.pdf	http://www.osc.gov/forms.htm	Yes	No	Fillable Printable
Form	OSC Form 14	Complaint of Possible Violation of USERRA	osc14.pdf	http://www.osc.gov/forms.htm	Yes	No	Printable Only
Form	OSC-12	Information About Filing a Whistleblower Disclosure with the Office of Special Counsel	osc12.date fixed.pdf	http://www.osc.gov/forms.htm	Yes	No	Fillable Printable

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,246	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,246	2,246
Annual IC Time Burden (Hours)	2,689	2,689
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.