Form SF 100 SF 100 Employer Information Report (EEO-1 Component 1)

NOTICE: SAMPLE EEO-1 COMPONENT 1 REPORT
As discussed in the 30-day Notice published in the Federal Register on May 2, 2023,
the EEOC created the Office of Enterprise Data and Analytics (OEDA) in May 2018
with the goal of creating a modern data and analytics organization at the agency. Since
its creation, OEDA, which administers the agency’s EEO data collections, including
the EEO-1 Component 1, has worked to modernize the collections and improve the
quality of data collected. OEDA has also streamlined functions, such as providing
additional self-service options, resource materials, and an online support message
center.
As part of its ongoing modernization efforts and in response to feedback from filers
in prior collections, OEDA has redesigned the format of the certified report(s)
generated by the EEO-1 Component 1 Online Filing System (OFS). The report(s),
which filers will be able to download and save as a PDF, contain several
enhancements to how information provided by filers is displayed. For example, the
updated report(s) now have delineated sections and headers that clearly identify the
information being displayed and filers’ answers to reporting questions such as
eligibility and federal contractor status.
Please Note: This is a “sample” EEO-1 Component 1 report generated by the EEOC’s
EEO-1 Component 1 Online Filing System (OFS). Filers are not permitted to submit
EEO-1 Component 1 workforce demographic data using this sample. The EEOC
requires electronic submission of EEO-1 Component 1 report(s) through the OFS, the
agency’s web-based data collection application (i.e., portal). The OFS is accessible at
www.eeocdata.org/eeo1.
The EEOC will only accept EEO-1 Component 1 report(s) submitted and certified
through the OFS. The EEOC will not accept reports submitted via paper or through
other non-OFS electronic means (e.g., email, CD-ROM). The EEOC will consider
filers submitting reports outside of the OFS to be non-compliant for purposes of their
mandatory EEO-1 Component 1 filing obligation.

U.S. EQUAL EMPLOYMENT OPPORTUNITY COMMISSION (EEOC)
[SPECIFIC REPORTING YEAR WILL BE INSERTED BY EEOC] EMPLOYER INFORMATION
REPORT (EEO-1 COMPONENT 1)

EEOC Standard Form 100 (SF 100)
Revised MM/2023
OMB No. 3046-0049
Expiration: MM/DD/YYYY

SECTION A – TYPE OF REPORT
SECTION B – EMPLOYER IDENTIFICATION

OFS COMPANY ID

EMPLOYER NAME

ADDRESS

CITY/TOWN

STATE

ZIP CODE

SECTION C – HEADQUARTERS OR ESTABLISHMENT-LEVEL IDENTIFICATION (if applicable)

HQ/ESTABLISHMENT-LEVEL UNIT ID

HEADQUARTERS OR ESTABLISHMENT-LEVEL NAME

HEADQUARTERS OR ESTABLISHMENT-LEVEL ADDRESS

CITY/TOWN

STATE

ZIP CODE

SECTION D – EMPLOYER IDENTIFICATION NUMBER (EIN)
SECTION E – EMPLOYER FILING ELIGIBILITY

□ YES (Employer Is Eligible to File) □ NO (Employer Is Not Eligible to File) □ EMPLOYER NO LONGER IN BUSINESS
SECTION F – FEDERAL CONTRACTOR DESIGNATION (if applicable)
Unique Entity ID (UEI):

□ YES (Single-Establishment Employer is Federal Contractor) □ YES (Multi-Establishment Employer is Federal Contractor)
□ YES (Headquarters is Federal Contractor) □ YES (Establishment is Federal Contractor) □ YES (One or More Establishments is Federal Contractor)
SECTION G – NAICS INFORMATION

Executive/Senior Level Officials and Managers
First/Mid-Level Officials and Managers
Professionals
Technicians
Sales Workers
Administrative Support Workers
Craft Workers
Operatives
Laborers and Helpers
Service Workers
CURRENT [SPECIFIC YEAR WILL BE
INSERTED BY EEOC] REPORTING YEAR
TOTAL
PRIOR [SPECIFIC YEAR TO BE INSERTED
BY EEOC] REPORTING YEAR TOTAL

SECTION I – WORKFORCE SNAPSHOT PERIOD

SECTION J – HEADQUARTERS OR ESTABLISHMENT-LEVEL COMMENTS (optional)

Two or More Races

American Indian or
Alaska Native

Native Hawaiian or
Other Pacific Islander

Asian

Black or
African American

White

Two or More Races

American Indian or
Alaska Native

Asian

Black or African
American

White

Female

Male

JOB CATEGORIES

Native Hawaiian or
Other Pacific Islander

SECTION H – WORKFORCE DEMOGRAPHIC DATA
Race/Ethnicity
Not Hispanic or Latino
Hispanic
Male
Female
or Latino

JA

Row
Total

U.S. EQUAL EMPLOYMENT OPPORTUNITY COMMISSION (EEOC)
[SPECIFIC REPORTING YEAR WILL BE INSERTED BY EEOC] EMPLOYER INFORMATION
REPORT (EEO-1 COMPONENT 1)

EEOC Standard Form 100 (SF 100)
Revised MM/2023
OMB No. 3046-0049
Expiration: MM/DD/YYYY

SECTION K – OFFICIAL CERTIFICATION OF SUBMISSION
EMPLOYER IDENTIFICATION

OFS COMPANY ID

EMPLOYER NAME

ADDRESS

CITY/TOWN

STATE

ZIP CODE

CERTIFICATION COMMENTS (optional)

CERTIFICATION STATEMENT

“I certify that the information, including any workforce demographic data, provided in this report is correct and true to the best of my knowledge
and was prepared in conformity with the directions set forth in the form and accompanying instructions.”
Knowingly and willfully false statements on this report are punishable by law, US Code, Title 18, Section 1001.
DATE OF CERTIFICATION

Name of Employer’s Certifying Official

Name of Primary POC

EMPLOYER’S CERTIFYING OFFICIAL

Title of Certifying Official

Email Address of Certifying Official

Telephone Number of Certifying Official

PRIMARY POINT OF CONTACT (POC) FOR EEO-1 COMPONENT 1 REPORTING
Title and Employer of Primary POC

Email Address of Primary POC

Telephone Number of Primary POC