NASA Complaint of Discrimination Form 1355

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form NF1355P Complaint of Discrimination Form	Form and Instruction	Modified	Available
2700-0163 NF1355P Supporting Statement A 2026.docx	Supporting Statement A	Uploaded 2026-08-25	Available
NASA-2026-0035-0003.pdf	Public Comments	Uploaded 2026-04-06	Available
NASA-2026-0035-0002.pdf	Public Comments	Uploaded 2026-04-06	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
219495	NASA Form 1355	Form and Instruction	Modified	Complaint of Discrimination Form

ICR Details

OMB Control No: 2700-0163	ICR Reference No: 202608-2700-001
Status: Received in OIRA	Previous ICR Reference No: 202310-2700-004
Agency/Subagency: NASA	Agency Tracking No:
Title: NASA Complaint of Discrimination Form 1355
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/25/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2026
Responses	60	60
Time Burden (Hours)	30	30
Cost Burden (Dollars)	738	0

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Abstract: The National Aeronautics and Space Administration (NASA) collects information from individuals who file a complaint of discrimination using NASA Complaint of Discrimination public form NF1355P. This information is necessary for NASA to comply with Federal Equal Employment Opportunity requirements and to ensure concerns of discrimination are addressed promptly and appropriately. NASA uses the information to process, track, and report discrimination complaints in accordance with applicable regulations and program management needs.

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Authorizing Statute(s): US Code: 29 USC 633a Name of Law: Age Discrimination in Employment Act
   PL: Pub.L. 92 - 261 11 Name of Law: qual Employment Opportunity Act of 1972
   US Code: 42 USC 2000e-16 Name of Law: 29 CFR Part 1614 - Federal Sector Equal Employment Opportunity
   US Code: 42 USC 2000e-16 Name of Law: Title VII of the Civil Rights Act of 1964
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 15643	04/06/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 54890	08/25/2026
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
NASA Form 1355	NF1355P	Complaint of Discrimination Form

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ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	60	60	0	0	0	0
Annual Time Burden (Hours)	30	30	0	0	0	0
Annual Cost Burden (Dollars)	738	0	0	738	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $52,612

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/25/2026

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