Information Collection

Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor

IC 13803 under ICR 201409-1250-007 · OMB 1250-0002.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1250-0002 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CC-4 Instructions French.pdf www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Instruction
CC-4 Instructions Korean.pdf www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Instruction
CC-4 Instructions Spanish.pdf www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Instruction
CC-4 Instructions Chinese-Simplified.pdf www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Instruction
CC-4 Instructions Chinese-Traditional.pdf www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Instruction
CC-4 Instructions Vietnamese.pdf www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Instruction
CC-4 Complaint Involving Employment Discrimination by Federal CC-4 Form Revised final French.pdf www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Form
CC-4 Complaint Involving Employment Discrimination by Federal CC-4 Form Revised final Korean.pdf www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Form
CC-4 Complaint Involving Employment Discrimination by Federal CC-4 Form Revised final Spanish.pdf www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Form
CC-4 Complaint Involving Employment Discrimination by Federal CC-4 Form Revised final Chinese-Simplified.pdf www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Form
CC-4 Complaint Involving Employment Discrimination by Federal CC-4 Form Revised final Chinese-Traditional.pdf www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Form
CC-4 Complaint Involving Employment Discrimination by Federal CC-4 Form Revised final Vietnamese.pdf www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Form
Non Material Change Memorandum_CC 4.pdf Non Material Change Memorandum_CC 4	IC Document
screenshot of complaint landing page.docx Screenshot of OFCCP's Complaint Landing Page	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 41 CFR 60-250.61(b) 41 CFR 60-741.61(c) 41 CFR 60-1.23(a) (To search for a specific CFR, visit the Code of Federal Regulations.)

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
Instruction			CC-4 Instructions Chinese-Traditional.pdf	http://www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Yes	No	Printable Only
Instruction			CC-4 Instructions Vietnamese.pdf	http://www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Yes	No	Printable Only
Form	CC-4	Complaint Involving Employment Discrimination by Federal Contractors or Subcontractors (French)	CC-4 Form Revised final French.pdf	http://www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Yes	Yes	Fillable Fileable
Form	CC-4	Complaint Involving Employment Discrimination by Federal Contractors or Subcontractors (Korean)	CC-4 Form Revised final Korean.pdf	http://www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Yes	Yes	Fillable Fileable
Form	CC-4	Complaint Involving Employment Discrimination by Federal Contractors or Subcontractors (Spanish)	CC-4 Form Revised final Spanish.pdf	http://www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Yes	Yes	Fillable Fileable
Form	CC-4	Complaint Involving Employment Discrimination by Federal Contractors or Subcontractors (Chinese - Simplified)	CC-4 Form Revised final Chinese-Simplified.pdf	http://www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Yes	Yes	Fillable Fileable
Form	CC-4	Complaint Involving Employment Discrimination by Federal Contractors or Subcontractors (Chinese - Traditional)	CC-4 Form Revised final Chinese-Traditional.pdf	http://www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Yes	Yes	Fillable Fileable
Form	CC-4	Complaint Involving Employment Discrimination by Federal Contractors or Subcontractors (Vietnamese)	CC-4 Form Revised final Vietnamese.pdf	http://www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Yes	Yes	Fillable Fileable
Instruction			CC-4 Instructions French.pdf	http://www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Yes	Yes	Printable Only
Instruction			CC-4 Instructions Korean.pdf	http://www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Yes	No	Printable Only
Instruction			CC-4 Instructions Spanish.pdf	http://www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Yes	No	Printable Only
Instruction			CC-4 Instructions Chinese-Simplified.pdf	http://www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Yes	No	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title: Complaint Case Files, DOL/ESA-2

FR Citation: 67 FR 16868

Number of Respondents: 747

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	747	747
Annual IC Time Burden (Hours)	747	747
Annual IC Cost Burden (Dollars)	52	52

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Non Material Change Memorandum_CC 4	Non Material Change Memorandum_CC 4.pdf	09/26/2014
Screenshot of OFCCP's Complaint Landing Page	screenshot of complaint landing page.docx	08/12/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.