Information Collection

NRC Form 655, "EEO Counselor's Report"

IC 253909 under ICR 202503-3150-002 · OMB 3150-0256.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3150-0256 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NRC Form 655 NRC Form 655, "EEO Counselor's Report"	Form and Instruction
Form NRC Form 655 EEO Counselor's Report NRC Form 655, "EEO Counselor's Report"	Form and Instruction
NRC Form 655 EEO Counselor's Report NRC 655 (03-06-2025) updated for EO 14168.pdf	Form and Instruction
NRC Form 655 EEO Counselor's Report NRC 655 (03-06-2025) updated for EO 14168.pdf	Form and Instruction

IC Title:

NRC Form 655, "EEO Counselor's Report"

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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
Form and Instruction	NRC Form 655				Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title: EEOC/GOVT-1 Equal Employment Opportunity in the Federal Government Complaint and Appeal Records

FR Citation: 71 FR 24704

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	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.

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