Information Collection

Office of Special Counsel for Immigration-Related Unfair Employment Practices Charge Form

IC 205699 under ICR 201701-1190-003 · OMB 1190-0018.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1190-0018 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OMB Number 1190-00 Office of Special Counsel for Immigration-Related Unfair Employment Practices Charge Form	Form and Instruction
OMB Number 1190-00 OSC Charge Form 1190-0018 OSC Charge Form_061516.pdf www.justice.gov/crt/about/osc	Form and Instruction

IC Title:

Office of Special Counsel for Immigration-Related Unfair Employment Practices Charge Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 28 CFR 44

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	OMB Number 1190-0018	OSC Charge Form	1190-0018 OSC Charge Form_061516.pdf	www.justice.gov/crt/about/osc	Yes	Yes	Fillable Fileable Signable

Line of Business: Litigation and Judicial Activities

Subfunction: Legal Investigation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 210

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	210	210
Annual IC Time Burden (Hours)	105	105
Annual IC Cost Burden (Dollars)	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.