Information Collection

Title II of the Americans with Disabilities Act of 1990/Section 504 Rehabilitation Act of 1973 Discrimination Compliant Form

IC 12906 under ICR 201005-1190-003 · OMB 1190-0009.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1190-0009 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1190-0009 Title II of the Americans with Disabilities Act of 1990/Section 504 Rehabilitation Act of 1973 Discrimination Compliant Form	Form
1190-0009 Title II of the Americans with Disabilities Act DRS Complaint Form.htm www.usdoj.gov/crt/ada/t2cmpfrm.htm	Form

IC Title:

Title II of the Americans with Disabilities Act of 1990/Section 504 Rehabilitation Act of 1973 Discrimination Compliant Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 28 CFR 35

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	1190-0009	Title II of the Americans with Disabilities Act	DRS Complaint Form.htm	http://www.usdoj.gov/crt/ada/t2cmpfrm.htm	Yes	No	Printable Only

Line of Business: Litigation and Judicial Activities

Subfunction: Legal Prosecution and Litigation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,000

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	Previously Approved
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	3,750	3,750
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.