Information Collection

Complaint of Employment Discrimination for the Decennial Census

IC 212587 under ICR 202011-0690-001 · OMB 0690-0015.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0690-0015 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CD-498A Complaint of Employment Discrimination for the Decennial Census	Form and Instruction
CD-498A Complaint of Employment Discrimination for the Decennial Form CD-498A 0690-0015.doc	Form and Instruction
CD-498A Complaint of Employment Discrimination for the Decennial Form CD498A (OCR Revisions submitted in Dec 2020) v2.docx	Form and Instruction

IC Title:

Complaint of Employment Discrimination for the Decennial Census

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

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	CD-498A	Complaint of Employment Discrimination for the Decennial Census	Form CD498A (OCR Revisions submitted in Dec 2020) v2.docx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

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	Previously Approved
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	200	200
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.