State and Local Government Information (EEO-4)

Forms and Documents

Document Name	Status
Form EEOC-164 State and Local Government Information (EEO-4) Form	Modified
Specific Instructions Justification_EEO-4.doc Supporting Statement A	2008-06-27

IC Document Collections

IC ID	Document Title	Status
29372	State and Local Government Information (EEO-4) Form	Modified

ICR Details

OMB Control No: 3046-0008	ICR Reference No: 200806-3046-002
Status: Historical Active	Previous ICR Reference No: 200307-3046-001
Agency/Subagency: EEOC	Agency Tracking No:
Title: State and Local Government Information (EEO-4)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/24/2008
	Date Received in OIRA: 07/03/2008
Terms of Clearance: This ICR has been approved without change with the following terms of clearance: The new expiration date for this form will be 1/31/2010. In order to receive OMB approval on the next submission, EEOC will revise the form and comply with OMB’s 1997 standards on race and ethnicity.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2010	36 Months From Approved	09/30/2008
Responses	12,036	0	10,000
Time Burden (Hours)	40,000	0	40,000
Cost Burden (Dollars)	0	0	0

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Abstract: EEO-4 data are used to investigate Charges of discrimination against state and local government and in EEOC systemic program decisions. Data are shared with other federal agencies and with 83 state and local FEPAs.

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Authorizing Statute(s): US Code: 42 USC 2000e-8(c) Name of Law: Title VII of the Civil Rights Act of 1964
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 21133	04/18/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 38208	07/03/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
State and Local Government Information (EEO-4)	EEOC-164	EEO-4

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ICR Summary of Burden

	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	12,036	10,000	0	0	2,036	0
Annual Time Burden (Hours)	40,000	40,000	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $200,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 07/03/2008

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