Information Collection

State and Local Government Information (EEO-4)

IC 29372 under ICR 202412-3046-005 · OMB 3046-0008.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 164 State and Local Government Information Report State and Local Government Information (EEO-4)	Form
EEO-4 Instruction Booklet (12.9.24).pdf	Instruction
EEO-4 Instruction Booklet (12.9.24).pdf	Instruction
164 State and Local Government Information Report EEO-4 Sample Report (12.9.24).pdf	Form
164 State and Local Government Information Report EEO-4 Sample Report (12.9.24).pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

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
Instruction					Yes	No	Printable Only
Form	164				Yes	Yes	Fillable Fileable

Line of Business: Litigation and Judicial Activities

Subfunction: Legal Investigation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,607

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	6,607	-7,042	13,649
Annual IC Time Burden (Hours)	18,094	-77,448	95,542
Annual IC Cost Burden (Dollars)	563,868	563,868	0

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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].