Information Collection

State and Local Government Information (EEO-4)

IC 29372 under ICR 201501-3046-003 · OMB 3046-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3046-0008 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 164 State and Local Government Information (EEO-4)	Form
164 EEO-4 REVISED_EEO-4_FORM_164.pdf egov.eeoc.gov/eeo4/	Form
164 EEO-4 (old) EE0-4 Form old.pdf	Form

IC Title:

State and Local Government Information (EEO-4)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

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
Form	164	EEO-4	REVISED_EEO-4_FORM_164.pdf	https://egov.eeoc.gov/eeo4/	Yes	Yes	Fillable Printable
Form	164	EEO-4 (old)	EE0-4 Form old.pdf		Yes	Yes	Fillable Printable

Line of Business: Litigation and Judicial Activities

Subfunction: Legal Investigation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 9,000

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 89 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	12,458	-1,602	14,060
Annual IC Time Burden (Hours)	89,188	16,003	73,185
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.