Information Collection

Waivers of Rights and Claims Under the ADEA; Informational Requirements

IC 29381 under ICR 202003-3046-001 · OMB 3046-0042.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3046-0042 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2016 60 Day ADEA PRA Notice.pdf 60 Day PRA ADEA Notice	IC Document
Published 30 Day FR Notice- ADEA PRA Waiver.pdf 30 Day PRA ADEA Notice	IC Document
[2.07.17 Revised] Supporting Statement for 2016 PRA ADEA Waiver.docx EEOC Supporting Statement	IC Document

IC Title:

Waivers of Rights and Claims Under the ADEA; Informational Requirements

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 1625.22

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

Line of Business: Litigation and Judicial Activities

Subfunction: Legal Investigation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 127

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	127	127
Annual IC Time Burden (Hours)	2,090	2,090
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
60 Day PRA ADEA Notice	2016 60 Day ADEA PRA Notice.pdf	08/16/2016
30 Day PRA ADEA Notice	Published 30 Day FR Notice- ADEA PRA Waiver.pdf	08/22/2016
EEOC Supporting Statement	[2.07.17 Revised] Supporting Statement for 2016 PRA ADEA Waiver.docx	02/07/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.