DHS Civil Rights and Civil Liberties Complaint and Privacy Waiver Form

ICR 202205-1601-003

OMB:

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2022-05-04
Supplementary Document
2022-05-04
Supplementary Document
2021-08-23
Supplementary Document
2021-08-23
Supplementary Document
2021-08-23
Supplementary Document
2021-07-01
IC Document Collections
ICR Details
202205-1601-003
Received in OIRA 202106-1601-001
DHS/OS
DHS Civil Rights and Civil Liberties Complaint and Privacy Waiver Form
Existing collection in use without an OMB Control Number   No
Regular 05/04/2022
  Requested Previously Approved
36 Months From Approved
692 0
692 0
0 0

The U.S. Department of Homeland Security (DHS), Office for Civil Rights and Civil Liberties (CRCL) reviews and investigates civil rights and civil liberties complaints filed by the public regarding U.S. Department of Homeland Security (DHS) policies and activities. Under 6 U.S.C. 345 and 42 U.S.C. 2000ee-1, CRCL reviews and assesses allegations involving a range of alleged civil rights and civil liberties abuses, such as: • Discrimination based on race, ethnicity, national origin, religion, sex, sexual orientation, gender identity, or disability; • Violation of rights while in immigration detention or as subject of immigration enforcement; • Discrimination or inappropriate questioning related to entry into the United States; • Violation of due process rights, such as the right to timely notice of charges or access to lawyer; • Violation of confidentiality provisions of the Violence Against Women Act; • Physical abuse or any other type of abuse; • Denial of meaningful access to DHS or DHS-supported programs, activities, or services due to limited English proficiency and • Any other civil rights, civil liberties, or human rights violation related to a Department program or activity, including allegations of discrimination by an organization or program that receives financial assistance from DHS.

US Code: 6 USC 345 Name of Law: Establishment of Officer for Civil Rights and Civil Liberties
   US Code: 42 USC 2000ee-1 Name of Law: Privacy and civil liberties officers
  
None

Not associated with rulemaking

  86 FR 33331 06/24/2021
86 FR 47133 08/23/2021
No

1
IC Title Form No. Form Name
DHS Civil Rights and Civil Liberties Complaint and Privacy Waiver Form

  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 692 0 0 692 0 0
Annual Time Burden (Hours) 692 0 0 692 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new information collection.

$197,460
No
    Yes
    Yes
No
No
No
No
Tyrone Huff 202 447-0106 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/04/2022


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