Information Collection

NASA Form 1355

IC 219495 under ICR 202608-2700-001 · OMB 2700-0163.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NF1355P Complaint of Discrimination Form NASA Form 1355	Form and Instruction
NF1355P Complaint of Discrimination Form NF1355P Complaint of Discrimination (For Public Use).pdf	Form and Instruction

IC Title:

NASA Form 1355

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1614

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	NF1355P				Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title: EEOC/GOVT1

FR Citation: 81 FR 81116

Number of Respondents: 60

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	60	0	60
Annual IC Time Burden (Hours)	30	0	30
Annual IC Cost Burden (Dollars)	738	738	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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].