Information Collection

Compliant Information Form and Justifications

IC 183761 under ICR 201101-1225-002 · OMB 1225-0077.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0077 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DL 1-2014A Compliant Information Form and Justifications	Form and Instruction
DL 1-2014A Complaint Information Form DL1-2014A.pdf	Form and Instruction

IC Title:

Compliant Information Form and Justifications

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 37.73(a)-(d) 29 CFR 37.74

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 and Instruction	DL 1-2014A	Complaint Information Form	DL1-2014A.pdf		Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title: DOL/OASAM-22

FR Citation: 67 FR 16816

Number of Respondents: 900

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	900	200	700
Annual IC Time Burden (Hours)	225	50	175
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.