(USED BY 706 AGENCIES TO PROCESS
CHARGES IN WORK SHARING AND DUAL FILING AGREEMENT.) THE PURPOSE OF
THE FORM IS TO ASSIST PERSONS WHO BELIEVE THEY HAVE BEEN AGGRIEVED
TO FILE CHARGES OF UNLAWFUL EMPLOYMENT PRACTICES WITH THE
COMMISSION. THE DATA IS USED BY THE EEOC IN ITS INVESTIGATION OF
ALLEGATIONS MADE BY THE INDIVIDUAL FILING THE CHARGE. SECTION
706(B) OF TITLE VII OF THE CIVIL RIGHTS ACT OF 1964, AS AMENDED,
REQUIRES THAT CHARGES BE IN WRITING UNDE
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:
(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;
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.