United States Department of Labor National Contact Cente

EXAMPLE:

Join the <Insert Associated Agency Name> mailing list free of charge!

Please reply back with the details below if you would like to be added to the mailing list.

- First & Last Name

- <Answer Agency Question>

- <Answer Agency Question>

- Title

- Mailing Address

- Telephone Number

- Mobile Number

- Can we text you? (*Standard messaging rates will apply)

This information collection is authorized under control number 1225-0059 (expires 01/31/2016). According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.  Public reporting burden for this collection of information is estimated to average 2 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Responding to this collection is voluntary. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor-OASAM, Office of the Chief Information Officer, Attention: Information Management Program, 200 Constitution Avenue, N.W., Room N1301, Washington, DC 20210 or email [email protected] and reference the OMB Control Number 1225-0059.

The Privacy Act of 1974 as amended (5 U.S.C. 552a) and 5 U.S.C. 301 authorize collection of this information. The purpose of this information is to obtain basic information used to add individuals to an agency mailing list. Completion of this form is voluntary; however, failure to provide the information may result in the inability to be added to the mailing list. Additional disclosures of this information may be to internal DOL agencies only.

*Please note that the indication for the US DOL office/agency changes depending on which agency mailing list that the customer is being solicited to be added to.