State and Local Government Information (EEO-4)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 164 State and Local Government Information (EEO-4)	Form	Modified	Available
EE0-4_Instructions[1].pdf	Supplementary Document	Uploaded 2015-02-25	Available
EE04Form[1].pdf	Supplementary Document	Uploaded 2015-02-25	Available
REVISED_EEO-4_FORM_164.pdf	Supplementary Document	Uploaded 2015-01-30	Available
EEO-4_30_Day_Notice.pdf	Supplementary Document	Uploaded 2015-01-29	Available
EE04Instructions_booklet_1_29_15.doc	Supplementary Document	Uploaded 2015-01-29	Available
EEO-4 60 Day Notice.pdf	Supplementary Document	Uploaded 2015-01-29	Available
eeo-4 supp statement_ 2.6.15.doc_rev.doc	Supporting Statement A	Uploaded 2015-02-06	Available
EEO-4.60day&EE 8.27.14.pdf	Supplementary Document	Uploaded 2014-09-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
29372	State and Local Government Information (EEO-4)	Form	Modified

ICR Details

OMB Control No: 3046-0008	ICR Reference No: 201501-3046-003
Status: Historical Active	Previous ICR Reference No: 201409-3046-003
Agency/Subagency: EEOC	Agency Tracking No:
Title: State and Local Government Information (EEO-4)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/15/2015
	Date Received in OIRA: 01/30/2015
Terms of Clearance: EEOC will provide two reporting options during the next reporting cycle, one with the form's previous demographic categories and one with the revised categories.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2018	36 Months From Approved	05/31/2015
Responses	12,458	0	14,060
Time Burden (Hours)	89,188	0	73,185
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.

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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
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 51155	08/27/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 2703	01/20/2015
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

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

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ICR Summary of Burden

table that charts list 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	12,458	14,060	0	-1,602	0	0
Annual Time Burden (Hours)	89,188	73,185	0	16,003	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The proposed revised form includes the following race and ethnicity categories: Hispanic or Latino; White; Black or African American; Asian; Native Hawaiian or Other Pacific Islander; American Indian or Alaska Native; and Two or More Races. The revised form has more cells than the prior version, and we estimate that the report will therefore take longer to complete, resulting in the increase in time burden

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Annual Cost to Federal Government: $226,549

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: 01/30/2015

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