Federal Contractor Veterans' Employment Report

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1293-0005 can be found here:

Documents and Forms

Document Name Document Type
Form VETS-4212 Federal Contractor Veterans' Employment Report Form
VETS-4212 Instructions.docx vets100.dol.gov/vets100/ Instruction
VETS-4212 Federal Contractor Veterans' Employment Report VETS-4212 Form.docx vets100.dol.gov/vets100/ Form
VETS-100A Federal Contractor Veterans' Employment Report vets-100a-form-rev-2014.pdf vets100.dol.gov/vets100/ Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Federal Contractor Veterans' Employment Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 41 CFR 61-300 41 CFR 61-250 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VETS-4212	Federal Contractor Veterans' Employment Report	VETS-4212 Form.docx	https://vets100.dol.gov/vets100/	Yes	Yes	Fillable Fileable
Instruction			VETS-4212 Instructions.docx	https://vets100.dol.gov/vets100/	Yes	Yes	Printable Only
Form and Instruction	VETS-100A	Federal Contractor Veterans' Employment Report	vets-100a-form-rev-2014.pdf	https://vets100.dol.gov/vets100/	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15,000	Number of Respondents for Small Entity: 10,000

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 65 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	315,000	-78,300	0	393,300
Annual IC Time Burden (Hours)	164,350	-35,000	0	199,350
Annual IC Cost Burden (Dollars)	1,080	0	1,080	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.