State and Local Government Information (EEO-4)

Forms and Documents

Document Name	Status
Form EEOC-164 State and Local Government Information (EEO-4) Form	Unchanged
EEO-4.60day&EE 8.27.14.pdf Supplementary Document	2014-09-04
Form 83i-fill[1].pdf_EEO_4_extension.pdf Supporting Statement B	2011-04-29
Specific InstructionsJustification_EEO-4 olcreview _re_8_9_11.doc Supporting Statement A	2011-08-09

IC Document Collections

IC ID	Document Title	Status
29372	State and Local Government Information (EEO-4) Form	Unchanged

ICR Details

OMB Control No: 3046-0008	ICR Reference No: 201409-3046-003
Status: Historical Active	Previous ICR Reference No: 201104-3046-004
Agency/Subagency: EEOC	Agency Tracking No:
Title: State and Local Government Information (EEO-4)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 09/04/2014
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/04/2014
	Date Received in OIRA: 09/04/2014
Terms of Clearance: This information collection request is approved for 6 months to allow EEOC to request extension of this collection following 60 and 30 days of public comment. Previous terms of clearance apply going forward.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2015	6 Months From Approved
Responses	14,060	0	0
Time Burden (Hours)	73,185	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: EEOC regulations require State and Local Governments with 100 or more employees to collect and retain in their records demographic information about their employees, and report this information to EEOC biennially in odd-numbered years. EEOC uses this information to enforce civil rights laws and shares it with the U. S. Department of Justice

Emergency Justfication: The Office of Management and Budget (OMB) has approved the EEO-4 through August 31, 2014. EEOC is now requesting an emergency extension without change of the form in order to continue to collect the data while EEOC completes the PRA process for the regular three year extension. EEOC published a joint request for an emergency extension of the previous approval for the EEO-4 and 60-day notice requesting public comment on proposed changes to the EEO-4 in the Federal Register on August 27, 2014. Please see the supplemental documents for a copy of that notice.

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Authorizing Statute(s): US Code: 42 USC 2000e-8(c) Name of Law: Title VII of the Civil Rights Act of 1964
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
State and Local Government Information (EEO-4)	EEOC-164	EEO-4

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	14,060	0	0	0	0	14,060
Annual Time Burden (Hours)	73,185	0	0	0	0	73,185
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $187,500

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/04/2014

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