Information Collection

Complaint of Employment Discrimination Involving a Federal Contractor or Subcontractor

IC 13803 under ICR 202512-1250-001 · OMB 1250-0002.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CC-4 Complaint of Employment Discrimination Involving a Federal Contractor or Subcontractor	Form and Instruction
Form CC-4 Complaint of Employment Discrimination Involving a Federal Contractor or Subcontractor Complaint of Employment Discrimination Involving a Federal Contractor or Subcontractor	Form and Instruction
CC-4 Complaint of Employment Discrimination Involving a Feder OFCCP Complaint Form 30-day Notice.docx	Form and Instruction
CC-4 Complaint of Employment Discrimination Involving a Feder OFCCP Complaint Form 2026.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 41 CFR 60-741.61 41 CFR 60-300.61 (To search for a specific CFR, visit the Code of Federal Regulations.)

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	CC-4				Yes	Yes	Fillable Printable

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: 95 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	100	0	100
Annual IC Time Burden (Hours)	100	0	100
Annual IC Cost Burden (Dollars)	64	-39	103

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].