Individual Complaint of Employment Discrimination

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2105-0556 can be found here:

Documents and Forms

Document Name Document Type
Form F1050-8 Individual Complaint of Employment Discrimination Form
F1050-8 Individual Complaint of Employment Discrimination Form DOT Complaint Form_7-31-09.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Individual Complaint of Employment Discrimination	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1614

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	F1050-8	Individual Complaint of Employment Discrimination Form	DOT Complaint Form_7-31-09.pdf		No		Paper Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	10	0	10
Annual IC Time Burden (Hours)	10	-6	16
Annual IC Cost Burden (Dollars)	0	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.