Information Collection

Section 503 Self-Identification Form

IC 200170 under ICR 201910-1250-004 · OMB 1250-0005.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1250-0005 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CC-305 Section 503 Self-Identification Form	Form and Instruction
CC-305 Voluntary Self-Identification of Disability 503 Self-ID Form 1 22 20 Final.docx	Form and Instruction
CC-305 Voluntary Self-Identification of Disability (with tracke 503 Self-ID Form (tracked changes).docx	Form and Instruction

IC Title:

Section 503 Self-Identification Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 41 CFR 60-741 (To search for a specific CFR, visit the Code of Federal Regulations.)

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	CC-305	Voluntary Self-Identification of Disability	503 Self-ID Form 1 22 20 Final.docx		Yes	No	Fillable Printable
Form and Instruction	CC-305	Voluntary Self-Identification of Disability (with tracked changes)	503 Self-ID Form (tracked changes).docx		Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 48,800,358

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	Previously Approved
Annual Number of Responses for this IC	48,800,358	7,101,198	41,699,160
Annual IC Time Burden (Hours)	3,904,029	429,099	3,474,930
Annual IC Cost Burden (Dollars)	0	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.