Information Collection Request
Ethnicity, Race, Gender and Disability Form (New)
ICR 202210-2030-001 · OMB unassigned · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 5800-068 Ethnicity, Race, Gender and Disability Form |
Form and Instruction | New | Repair queued |
 2717ss01.docx |
Supporting Statement A | Uploaded 2022-10-28 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 256661 |  Ethnicity, Race, Gender and Disability Form |
Form and Instruction | New |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | EPA/OMS |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Agency Tracking No | 2717.01 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |