Information Collection

Complaint of Employment Discrimination Involving a Federal Contractor or Subcontractor

IC 13803 under ICR 202304-1250-002 · OMB 1250-0002.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1250-0002 can be found here:

Documents and Forms

Document Name Document Type
Form CC-4 Complaint of Employment Discrimination Involving a Federal Contractor or Subcontractor Form and Instruction
CC-4 Complaint of Employment Discrimination Involving a Feder Proposed OFCCP Complaint Form 4.7.2023.docx Form and Instruction
CC-4 Complaint of Employment Discrimination Involving a Feder Proposed OFCCP Complaint Form 06.06.23.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Complaint of Employment Discrimination Involving a Federal Contractor or Subcontractor	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 41 CFR 60-1.23 41 CFR 60-300.61 41 CFR 60-741.61 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CC-4	Complaint of Employment Discrimination Involving a Federal Contractor or Subcontractor	Proposed OFCCP Complaint Form 06.06.23.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title: Complaint Case Files, DOL/ESA-2	FR Citation: 67 FR 16868

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	100	-797	897
Annual IC Time Burden (Hours)	100	-797	897
Annual IC Cost Burden (Dollars)	103	-66	169

Documents for IC

Title	Document	Date Uploaded
No associated records found

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