Information Collection

Unfair Immigration-Related Employment Practices Complaint Form

IC 217474 under ICR 202506-1125-003 · OMB 1125-0016.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form EOIR-58 Unfair Immigration-Related Employment Practices Complaint Form	Form
Form EOIR-58 Unfair Immigration-Related Employment Practices Complaint Form Unfair Immigration-Related Employment Practices Complaint Form	Form
EOIR-58-Instructions_rev-2025_draft.docx	Instruction
EOIR-58-Instructions_rev-2025_draft.docx	Instruction
EOIR-58 Unfair Immigration-Related Employment Practices Complain EOIR-58_rev-2025_draft-v4.docx	Form
EOIR-58 Unfair Immigration-Related Employment Practices Complain EOIR-58_rev-2025_draft-v4.docx	Form

IC Title:

Agency IC Tracking Number:

EOIR-58

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 28 CFR 68

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	EOIR-58				Yes	Yes	Fillable Fileable Signable
Instruction					Yes	Yes	Printable Only

Line of Business: Litigation and Judicial Activities

Subfunction: Legal Prosecution and Litigation

Privacy Act System of Records

Title: EOIR-002, OCAHO Cases Management System

FR Citation: 84 FR 42016

Number of Respondents: 38

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	38	12	26
Annual IC Time Burden (Hours)	38	12	26
Annual IC Cost Burden (Dollars)	954	694	260

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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