Federal Government

Workplace Discrimination Complaints

OMB: 3060-1237

IC ID: 241980

Information Collection (IC) Details

View Information Collection (IC)

Federal Government OWD
 
No Modified
 
Voluntary
 
29 CFR 1614.106

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form FCC Form 5621 INFORMAL COMPLAINT of DISCRIMINATION EEO Form 5621 - Informal Complaint.pdf Yes Yes Fillable Fileable Signable

General Government Central Fiscal Operations

 

12 0
   
Federal Government
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 12 0 0 0 0 12
Annual IC Time Burden (Hours) 34 0 0 0 0 34
Annual IC Cost Burden (Dollars) 4,000 0 0 0 0 4,000

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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