Workplace Discrimination Complaints

ICR 202206-3060-015

OMB: 3060-1237

Federal Form Document

IC Document Collections
IC ID
Document
Title
Status
241980 Modified
226756 Modified
ICR Details
3060-1237 202206-3060-015
Active 202004-3060-043
FCC OWD
Workplace Discrimination Complaints
No material or nonsubstantive change to a currently approved collection   No
Delegated
Approved without change 06/21/2022
Retrieve Notice of Action (NOA) 06/21/2022
  Inventory as of this Action Requested Previously Approved
05/31/2023 05/31/2023 05/31/2023
23 0 23
67 0 67
8,000 0 8,000

The Commission is requesting approval for non-substantive changes to the forms associated with the FCC’s Informal Complaint of Discrimination (FCC Form 5621) and the FCC’s Formal Complaint of Discrimination (FCC Form 5622). As part of the development of an online application for its informal and formal complaint process, the FCC discovered that there were inconsistencies in the Privacy Act Statements included on these forms and the FCC’s online application for submitting complaints which could prove confusing to complainants, and could potentially provide insufficient information about the Privacy Act routine uses and whether submitting information is mandatory or voluntary. To remedy this issue, the FCC has revised its Privacy Act Statements on both forms. The updates to this collection will cause no change in the burden estimates or reporting and record keeping requirements that the Commission submitted (and which OMB subsequently approved) in 2017 and extended in 2020. FCC employees, former employees and applicants for employment who believe they were denied equal employment opportunity based on race, color, religion, gender, national origin, age, physical or mental disability, genetic information and/or reprisal will complete FCC-5621 and FCC-5622.

US Code: 42 USC 2000ff-6(f)
   US Code: 29 USC 206(d)
   US Code: 29 USC 6333a
   US Code: 29 USC 791
   US Code: 29 USC 794a
   US Code: 42 USC 2000e-16
  
None

Not associated with rulemaking

  85 FR 16625 03/24/2020
85 FR 16625 03/24/2020
No

2
IC Title Form No. Form Name
Federal Government FCC Form 5621 INFORMAL COMPLAINT of DISCRIMINATION
Individuals or Households FCC Form 5622 FORMAL COMPLAINT OF DISCRIMINATION

  Total Approved 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 23 23 0 0 0 0
Annual Time Burden (Hours) 67 67 0 0 0 0
Annual Cost Burden (Dollars) 8,000 8,000 0 0 0 0
No
No
The Commission is reporting an adjustment to this information collection. The total number of respondents and total annual responses decreased by 3, the total annual burden hours decreased by 24 hours and the total annual costs decreased by $7,000. These decreases are based on the most currently available data to the Commission.

$226,961
No
    Yes
    Yes
No
No
No
No
Cynthia Bryant 202 418-8165 [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.
06/21/2022


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