OMB control number

NASA Complaint of Discrimination Form 1355

OMB 2700-0163 · NASA.

OMB 2700-0163

This information collection is necessary to ensure compliance with the Civil Rights Act of 1964, the Equal Opportunity Act of 1972, the Age Discrimination in Employment Act of 1972, and NASA policy. NASA strives to provide and maintain a work environment that is free of all forms of discrimination, including discriminatory harassment, as well as reprisal or retaliation for engaging in protected EEO activity. NASA also seeks to address harassing conduct at the earliest possible stage, before it becomes severe or persuasive. This information collection enables NASA to obtain information, in a structured manner, from non-federal employment applicants who believe they were discriminated against based on any of the following: race, color, religion, sex (to include sexual harassment, sex stereotyping, pregnancy, and gender identity), age, national origin, disability (mental and/or physical), genetic information (including family medical history), sexual orientation, reprisal, and class complaint. Pursuant to MD-715, EEO Reporting Requirements for Federal Agencies, it is also NASA policy to promote the full realization of a model EEO program by effectively considering and addressing concerns that arise under Title VII and Section 501 of the Rehabilitation Act. NASA's efforts to be a model Agency for EEO include identification of and strategies to remove deficiencies in EEO programs and barriers to EEO in any aspect of Agency policies, programs, or practices including, but not limited to, outreach and recruiting, hiring, promoting, training, awareness, and facilities and program accessibility for employees of NASA. Model EEO efforts include monitoring strategies and employment practices in the areas of hiring, transfers, reassignments, promotions, awards, benefits, and separations. These efforts are undertaken to help gain and maintain a talented NASA workforce that is reflective of the Nation's demographic diversity. This information collection also supports NASA’s self-assessment processes in that regard.

The latest form for NASA Complaint of Discrimination Form 1355 expires 2026-12-31 and is listed under ICR 202310-2700-004.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 1355 NASA Form 1355Form and Instruction
2700-0163 2023 NASA Complaints of Discrimination.docxSupporting Statement A
NASA Form 1355 Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202310-2700-004 Reinstatement with change of a previously approved collection 2023-11-06 Approved with change
201806-2700-002 Extension without change of a currently approved collection 2018-06-15 Approved without change
201508-2700-003 Existing collection in use without an OMB Control Number 2015-09-14 Approved with change