DHS Civil Rights Compliance Form

ICR 201801-1601-001

OMB: 1601-0024

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Removed
Form and Instruction
Modified
Supporting Statement A
2018-01-05
Supplementary Document
2016-12-14
Supplementary Document
2016-11-28
Supplementary Document
2016-11-28
Supplementary Document
2016-11-28
Supplementary Document
2016-11-28
Supplementary Document
2016-11-28
Supplementary Document
2016-11-28
Supplementary Document
2016-11-28
Supplementary Document
2016-11-28
Supplementary Document
2016-11-28
Supplementary Document
2016-11-28
ICR Details
1601-0024 201801-1601-001
Active 201611-1601-001
DHS/OS
DHS Civil Rights Compliance Form
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 01/30/2018
Retrieve Notice of Action (NOA) 01/30/2018
During the course of this review, the agency made a significant effort to reduce burden on respondents. The agency will continue to keep an eye toward any ways to further streamline or reduce burden as it implements this new collection.
  Inventory as of this Action Requested Previously Approved
01/31/2021 36 Months From Approved
2,220 0 0
6,660 0 0
0 0 0

The purpose of the information collection is to advise recipients of their civil rights obligations; obtain an assurance of compliance from each recipient, and collect pertinent civil rights information to ascertain if the recipient has in place adequate policies and procedures to achieve compliance, and to determine what, if any, further action may be needed to ensure the recipient is in compliance and will carry out its programs and activities in a nondiscriminatory manner.

US Code: 29 USC 794 Name of Law: Section 504 of the Rehabilitation Act of 1973
   US Code: 42 USC 2000d-1 Name of Law: Civil Rights Act of 1964
   US Code: 42 USC 6101 Name of Law: Age Discrimination Act of 1975
   US Code: 20 USC 1681 Name of Law: Title IX of the Education Amendments of 1972
  
None

Not associated with rulemaking

  81 FR 65390 09/22/2016
81 FR 90372 12/14/2016
Yes

  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 2,220 0 0 4,385 -2,165 0
Annual Time Burden (Hours) 6,660 0 0 15,320 -8,660 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new collection.

$466,489
No
    No
    No
No
No
No
Uncollected
Tyrone Huff 202 447-0106 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
01/30/2018


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