OMB control number
DHS Individual Complaint of Employment Discrimination
OMB 1610-0001 · DHS/OCR.
OMB 1610-0001
This form provides information necessary for processing formal complaints of employment discrimination in accordance with EEOC Management Directive (EEO-MD) 110, and 29 C.F.R. part 1614.
The latest form for DHS Individual Complaint of Employment Discrimination expires 2027-04-30 and is listed under ICR 202306-1610-001.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form DHS Form 3090-3 DHS Individual Complaint of Employment Discrimination | Form and Instruction |
| DHS Form 3090 (01.25.2022) (003).pdf | Supplementary Document |
| 30_Day_FRN_DHS-2023-0013-0002.pdf | Supplementary Document |
| 60_Day_FRN_DHS-2023-0013 (3).pdf | Supplementary Document |
 1610-0001 - Supporting Statement A - DHS Individual Complaint of Employment - CRCL updates Jan2023 (1).docx | Supporting Statement A |
| 29 USC 206.pdf | Supplementary Document |
| Executive Order 11478.docx | Supplementary Document |
| 42 USC 2000ff.pdf | Supplementary Document |
| 42 USC 2000e.pdf | Supplementary Document |
| 29 USC 791.pdf | Supplementary Document |
| 29 USC 621.pdf | Supplementary Document |
| EEO Director 462 MEMORANDUM April 2011.pdf | Supplementary Document |
| PART 1614--FEDERAL SECTOR EQUAL EMPLOYMENT OPPORTUNITY.pdf | Supplementary Document |
 DHS Individual Complaint of Employment Discrimination |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202306-1610-001 | Extension without change of a currently approved collection | 2023-06-30 | Approved without change | |
| 202103-1610-001 | Reinstatement without change of a previously approved collection | 2021-08-02 | Approved without change | |
| 201504-1610-001 | Reinstatement with change of a previously approved collection | 2015-04-29 | Approved without change | |
| 201106-1610-002 | Revision of a currently approved collection | 2011-06-30 | Approved without change | |
| 200803-1610-001 | Extension without change of a currently approved collection | 2008-04-21 | Approved without change | |
| 200501-1610-001 | New collection (Request for a new OMB Control Number) | 2005-01-11 | Approved without change |