DHS Civil Rights Compliance Form

ICR 202301-1601-001

OMB: 1601-0024

Federal Form Document

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1601-0024 can be found here:

2024-06-24 - Revision of a currently approved collection

Forms and Documents

Document Name	Status
Form DHS Form 3095 DHS Civil Rights Compliance Form 3095 Form and Instruction	Modified
OMB Form 83-C for DHS Form 3095.pdf Justification for No Material/Nonsubstantive Change	2023-01-11
1601-0024_Supporting Statement A for Renewal DHS Form 3095.docx Supporting Statement A	2023-01-11
Narrative of Changes Table - DHS Civil Rights Evaluation Tool Updated 2.16.2021.docx Supplementary Document	2023-01-11
42 USC 6101.pdf Supplementary Document	2016-11-28
42 USC 2000d-1.pdf Supplementary Document	2016-11-28
29 USC 794.pdf Supplementary Document	2016-11-28
28 CFR Part 42.docx Supplementary Document	2016-11-28
20 USC 1681.pdf Supplementary Document	2016-11-28
44 CFR Part 19.pdf Supplementary Document	2016-11-28
44 CFR Part 7.pdf Supplementary Document	2016-11-28
6 CFR Part 21.pdf Supplementary Document	2016-11-28
6 CFR Part 17.pdf Supplementary Document	2016-11-28

IC Document Collections

IC ID	Document Title	Status
224608	DHS Civil Rights Compliance Form 3095 Form and Instruction	Modified

ICR Details

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