Information Collection

Individual Complaint of Employment Discrimination

IC 44070 under ICR 201508-2105-002 · OMB 2105-0556.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2105-0556 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DOT F 1050–8 Individual Complaint of Employment Discrimination	Form and Instruction
DOT F 1050–8 Individual Complaint of Employment DOT_F_1050–8_One DOT Complaint Form_Blank_JULY 2015.docx	Form and Instruction

IC Title:

Individual Complaint of Employment Discrimination

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1614

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 and Instruction	DOT F 1050â8	Individual Complaint of Employment	DOT_F_1050â8_One DOT Complaint Form_Blank_JULY 2015.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title: EEOC/GOVT-1 - Equal Employment Opportunity in the Federal Government Complaint and Appeal Records

FR Citation: 67 FR 49354

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	10	0	10
Annual IC Time Burden (Hours)	30	0	30
Annual IC Cost Burden (Dollars)	58	58	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.