Unfair Immigration-Related Employment Practices Complaint Form

Forms and Documents

Document	Type	Status	Availability
Form EOIR-58 Unfair Immigration-Related Employment Practices Complaint Form	Form and Instruction	Modified	Repair queued
EOIR-58_SUPPORTING STATEMENT_12.2.2021_Signed.pdf	Supporting Statement A	Uploaded 2021-12-02	Repair queued
5. 8 USC 1324b.pdf	Supplementary Document	Uploaded 2015-07-15	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
217474	Unfair Immigration-Related Employment Practices Complaint Form	Form and Instruction	Modified

ICR Details

OMB Control No: 1125-0016	ICR Reference No: 202109-1125-006
Status: Received in OIRA	Previous ICR Reference No: 201807-1125-001
Agency/Subagency: DOJ/EOIR	Agency Tracking No: EOIR-58
Title: Unfair Immigration-Related Employment Practices Complaint Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/07/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2022
Responses	26	22
Time Burden (Hours)	26	22
Cost Burden (Dollars)	260	1,436

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Abstract: Section 274B of the INA prohibits: employment discrimination on the basis of citizenship status or national origin; retaliation or intimidation by an employer against an individual seeking to exercise his or her rights under this section; and "document abuse" or overdocumentation by the employer, which occurs when the employer asks an applicant or employee for more or different documents than required for employment eligibility verification under INA section 274A, with the intent of discriminating against the employee in violation of section 274B.

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Authorizing Statute(s): US Code: 8 USC 1324b Name of Law: INA
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 53679	09/28/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 68287	12/01/2021
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Unfair Immigration-Related Employment Practices Complaint Form	EOIR-58	Unfair Immigration-Related Employment Practices Complaint Form

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ICR Summary of Burden

	Total Request	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	26	22	0	4	0	0
Annual Time Burden (Hours)	26	22	0	4	0	0
Annual Cost Burden (Dollars)	260	1,436	0	-1,176	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Modified estimated time to complete form from 30 minutes to 1 hour. Removed third party disclosure costs as inadvertently entered previously.

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Annual Cost to Federal Government: $1,459

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 12/07/2021

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