Information Collection

Individuals or Households

IC 268655 under ICR 202405-3060-009 · OMB 3060-1258.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-1258 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Individuals or Households

Agency IC Tracking Number:

OWD

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1614.603

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title: EEOC/GOVT1, EEO Fed. GOVT, Complaint&Appeals Records

FR Citation: 81 FR 81116

Number of Respondents: 1

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	1,875	1,875

Documents for IC

table that charts IC Documents
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.