Complaint of Employment Discrimination Involving a Federal Contractor or Subcontractor

Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor

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 Form Complaint Form.docx Form and Instruction

Information Collection (IC) Details

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 60-300.61 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 Form	Complaint Form.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 %

	Requested	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	103	103

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.