Information Collection

Individual Complaint of Employment Discrimination

IC 44070 under ICR 200907-2105-002 · OMB 2105-0556.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.