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OFCCP Complaint Form
OFCCP Complaint Form
OMB: 1215-0131
IC ID: 13803
OMB.report
DOL/ESA
OMB 1215-0131
ICR 200710-1215-001
IC 13803
( )
Documents and Forms
Document Name
Document Type
Form CC-4
OFCCP Complaint Form
Form and Instruction
CC-4 Complaint of Discrimination in Employment Under Federal
NewCC-4Wchgs-09-25-07.pdf
Form and Instruction
CC-4 OFCCP Complaint Form
CC-4ComplaintForm-06-13-07.pdf
www.dol.gov/esa/regs/compliance/ofccp/pdf/pdfstart.htm
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
OFCCP Complaint Form
Agency IC Tracking Number:
Is this a Common Form?
Yes
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
41 CFR 60-1.23(a) 41 CFR 60-250.61(b) 41 CFR 60-741.61(c) (To search for a specific CFR, visit the
Code of Federal Regulations.
)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
CC-4
Complaint of Discrimination in Employment Under Federal Government Contracts
NewCC-4Wchgs-09-25-07.pdf
Yes
Yes
Fillable Printable
Form and Instruction
CC-4
OFCCP Complaint Form
CC-4ComplaintForm-06-13-07.pdf
http://www.dol.gov/esa/regs/compliance/ofccp/pdf/pdfstart.htm
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Labor Rights Management
Privacy Act System of Records
Title:
OFCCP Complaint Form
FR Citation:
5 FR 552
Number of Respondents:
594
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
19 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
594
0
0
-254
0
848
Annual IC Time Burden (Hours)
760
0
0
-325
0
1,085
Annual IC Cost Burden (Dollars)
261
0
0
261
0
0
Documents for IC
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.