Information Collection Request

USDA Program Discrimination Complaint Form

ICR 202212-0508-001 · OMB 0508-0002 · Active

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0508-0002 can be found here:

Forms and Documents

Forms and supporting documents for this ICR
Document	Type	Status	Availability
Program Discrimination Complaint Form (Individuals)	Form	Modified	Available
Program Discrimination Complaint Form (Individuals)	Form	Modified	Repair queued
Program Discrimination Complaint Form (State, Local and Tribal Government)	Form	Modified	Available
Program Discrimination Complaint Form (State, Local and Tribal Government)	Form	Modified	Repair queued
Program Discrimination Complaint Form (Private Sector)	Form	Modified	Available
Program Discrimination Complaint Form (Private Sector)	Form	Modified	Repair queued
0508-0002 - Change Justification for Spanish version.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-12-07	Repair queued
0508-0002 - Change Justification for Spanish version.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-12-07	Repair queued
OMB 0508-0002 - language changes_4262022 (FINAL) 10.04.22.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-10-04	Available
OMB 0508-0002 - language changes_4262022 (FINAL) 10.04.22.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-10-04	Missing upstream
Supporting Statement 2021 Program Complaint Form 0508-0002.docx	Supporting Statement A	Uploaded 2021-02-25	Available
Supporting Statement 2021 Program Complaint Form 0508-0002.docx	Supporting Statement A	Uploaded 2021-02-25	Repair queued

Information collection document groups
IC ID	Collection	Type	Status
987	Program Discrimination Complaint Form (Individuals)	Form	Modified
987	Program Discrimination Complaint Form (Individuals)	Form	Modified
198399	Program Discrimination Complaint Form (State, Local and Tribal Government)	Form	Modified
198399	Program Discrimination Complaint Form (State, Local and Tribal Government)	Form	Modified
198398	Program Discrimination Complaint Form (Private Sector)	Form	Modified
198398	Program Discrimination Complaint Form (Private Sector)	Form	Modified

Record metadata
Status	Active
Agency/Subagency	USDA/AgOCR
OMB Control No	0508-0002
Type of Information Collection	No material or nonsubstantive change to a currently approved collection
Previous ICR Reference No	202210-0508-001
Date Submitted to OIRA	2022-12-07
Requested Expiration Date	1969-12-31