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Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor
Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor
OMB: 1250-0002
IC ID: 13803
OMB.report
DOL/OFCCP
OMB 1250-0002
ICR 201910-1250-003
IC 13803
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1250-0002 can be found here:
2023-09-21 - No material or nonsubstantive change to a currently approved collection
2023-04-28 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
cc 4 instructions.docx
webapps.dol.gov/ofccp-claims/help/english.html
Instruction
CC-4 Complaint Involving Employment Discrimination by a Feder
ComplaintForm.docx
webapps.dol.gov/ofccp-claims/english.html
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
41 CFR 60-741.61 41 CFR 60-1.23 41 CFR 60-300.61 (To search for a specific CFR, visit the
Code of Federal Regulations.
)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
cc 4 instructions.docx
https://webapps.dol.gov/ofccp-claims/help/english.html
Yes
Yes
Fillable Fileable
Form
CC-4
Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor
ComplaintForm.docx
https://webapps.dol.gov/ofccp-claims/english.html
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Labor Rights Management
Privacy Act System of Records
Title:
Complaint Case Files, DOL/ESA-2
FR Citation:
67 FR 16868
Number of Respondents:
897
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
90 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
897
0
0
144
0
753
Annual IC Time Burden (Hours)
897
0
0
144
0
753
Annual IC Cost Burden (Dollars)
169
0
0
107
0
62
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.