Complaint of Employment Discrimination for the Decennial Census

Reporting Process for Complaint of Employment Discrimination Used by Permanent Employees and Applicants for Employment at DOC and Complaint of Employment Discrimination for the Decennial Census

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0690-0015 can be found here:

Documents and Forms

Document Name Document Type
Form CD-498A Complaint of Employment Discrimination for the Decennial Census Form and Instruction
CD-498A Complaint of Employment Discrimination Form.CD.498A.0690-0015.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Complaint of Employment Discrimination for the Decennial Census	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CD-498A	Complaint of Employment Discrimination	Form.CD.498A.0690-0015.doc		No		Paper Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	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.