Information Collection

Federal Contractor Veterans' Employment Report

IC 14762 under ICR 202606-1293-001 · OMB 1293-0005.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form E Form VETS-4212 Federal Contractor Veterans' Employment Report	Form
Form E Form VETS-4212 Federal Contractor Veterans' Employment Report	Form
Form 1293-0005 FEDERAL CONTRACTOR VETERANS’ EMPLOYMENT REPORT VETS-4212 Federal Contractor Veterans' Employment Report	Form and Instruction
Form 1293-0005 FEDERAL CONTRACTOR VETERANS’ EMPLOYMENT REPORT VETS-4212 Federal Contractor Veterans' Employment Report	Form and Instruction
Login.jpg vets4212.dol.gov/vets4212	Other-Log-in Screen
Login.jpg vets4212.dol.gov/vets4212	Other-Log-in Screen
E Form VETS-4212 Form.jpg vets4212.dol.gov/vets4212	Form
E Form VETS-4212 Form.jpg vets4212.dol.gov/vets4212	Form
1293-0005 FEDERAL CONTRACTOR VETERANS’ EMPLOYMENT REPORT VETS-4212 VETS-4212-Form_New_Address.pdf vets4212.dol.gov/vets4212/	Form and Instruction
1293-0005 FEDERAL CONTRACTOR VETERANS’ EMPLOYMENT REPORT VETS-4212 VETS-4212-Form_New_Address.pdf vets4212.dol.gov/vets4212/	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 41 CFR 61-300 (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.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	E Form	https://vets4212.dol.gov/vets4212	Yes	Yes	Fillable Fileable Signable
Other-Log-in Screen		https://vets4212.dol.gov/vets4212	Yes	Yes	Fillable Fileable Signable
Form and Instruction	1293-0005	https://vets4212.dol.gov/vets4212/	Yes	Yes	Fillable Fileable Signable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 21,000

Number of Respondents for Small Entity: 10,000

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 98 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	378,000	378,000
Annual IC Time Burden (Hours)	128,520	128,520
Annual IC Cost Burden (Dollars)	1,340	1,340

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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