OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Individual Complaint of Employment Discrimination

OMB 2105-0556 · DOT/OST.

OMB 2105-0556

The DOT will utilize the form to collect information necessary to process Equal Employment Opportunity (EEO) discrimination complaints filed by employees, former employees, and applicants for employment with the Department. These complaints are processed in accordance with the Equal Employment Opportunity Commission’s regulations, 29 CFR part 1614, as amended. The DOT will use the form to: (a) request requisite information from the individual for processing his or her EEO employment discrimination complaint; and (b) obtain information to identify an individual or his or her attorney or other representative, if appropriate.

The latest form for Individual Complaint of Employment Discrimination expires 2026-06-30 and is listed under ICR 202304-2105-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form DOT F 1050–8 Individual Complaint of EmploymentForm and Instruction
Blank ONEDOT Formal Complaint Form 2105-0556.rtfSupplementary Document
Supporting Statement A for 2105-0556_April 2026 (1).docxSupporting Statement A
GINA.pdfSupplementary Document
29 CFR Part 1614.pdfSupplementary Document
Individual Complaint of Employment Discrimination Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202607-2105-001 Reinstatement with change of a previously approved collection 2026-07-13
202304-2105-001 Extension without change of a currently approved collection 2023-04-18 Approved without change
202001-2105-001 Extension without change of a currently approved collection 2020-01-29 Approved without change
201612-2105-001 Extension without change of a currently approved collection 2016-12-20 Approved without change
201508-2105-002 Reinstatement without change of a previously approved collection 2015-11-16 Approved without change
201210-2105-001 Reinstatement without change of a previously approved collection 2013-03-13 Approved without change
200907-2105-002 Revision of a currently approved collection 2009-07-31 Approved without change
200606-2105-001 New collection (Request for a new OMB Control Number) 2006-06-15 Approved without change