DHS Individual Complaint of Employment Discrimination

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1610-0001 can be found here:

Documents and Forms

Document Name Document Type
Form DHS Form 3090 DHS Individual Complaint of Employment Discrimination Form and Instruction
DHS Form 3090 DHS Individual Compliant of Employment Discrimination DHS Form 3090-1.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	DHS Individual Complaint of Employment Discrimination	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 1614

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DHS Form 3090	DHS Individual Compliant of Employment Discrimination	DHS Form 3090-1.pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,200	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	600	600
Annual IC Cost Burden (Dollars)	0	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.