Information Collection

NASA Form 1355

IC 219495 under ICR 202310-2700-004 · OMB 2700-0163.

Documents and Forms

Document Name Document Type
Form 1355 NASA Form 1355 Form and Instruction
1355 Complaint of Discrimination - NASA NF1355.pdf Form and Instruction
1355 Complaint of Discrimination - NASA NF1355.pdf Form and Instruction
1355P Complaint of Discrimination - Public NF1355P.pdf Form and Instruction
1355P Complaint of Discrimination - Public NF1355P.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NASA Form 1355	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1355	Complaint of Discrimination - NASA	NF1355.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	1355P	Complaint of Discrimination - Public	NF1355P.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records
Title: EEOC/GOVT1	FR Citation: 81 FR 81116

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

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.