Information Collection

Applicant Background Questionnaire: Race, National Origin, Gender and Disability Demographics

IC 179894 under ICR 200710-2030-002 · OMB 2030-0045.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2248form03 Applicant Background Questionnaire: Race, National Origin, Gender and Disability Demographics	Form
2248form03 Applicant Background Questionnaire: Race, National Origi 2248form03.doc	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1614.601

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	2248form03	Applicant Background Questionnaire: Race, National Origin, Gender, and Disability Demographics	2248form03.doc		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 32,590

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	32,590	32,590
Annual IC Time Burden (Hours)	15,209	15,209
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.