Unfair Immigration-Related Employment Practices Complaint Form

ICR 202109-1125-006

OMB: 1125-0016

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2021-12-02
Supplementary Document
2015-07-15
IC Document Collections
ICR Details
1125-0016 202109-1125-006
Received in OIRA 201807-1125-001
DOJ/EOIR EOIR-58
Unfair Immigration-Related Employment Practices Complaint Form
Revision of a currently approved collection   No
Regular 12/07/2021
  Requested Previously Approved
36 Months From Approved 01/31/2022
26 22
26 22
260 1,436

Section 274B of the INA prohibits: employment discrimination on the basis of citizenship status or national origin; retaliation or intimidation by an employer against an individual seeking to exercise his or her rights under this section; and "document abuse" or overdocumentation by the employer, which occurs when the employer asks an applicant or employee for more or different documents than required for employment eligibility verification under INA section 274A, with the intent of discriminating against the employee in violation of section 274B.

US Code: 8 USC 1324b Name of Law: INA
  
None

Not associated with rulemaking

  86 FR 53679 09/28/2021
86 FR 68287 12/01/2021
Yes

1
IC Title Form No. Form Name
Unfair Immigration-Related Employment Practices Complaint Form EOIR-58 Unfair Immigration-Related Employment Practices Complaint Form

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 26 22 0 4 0 0
Annual Time Burden (Hours) 26 22 0 4 0 0
Annual Cost Burden (Dollars) 260 1,436 0 -1,176 0 0
Yes
Miscellaneous Actions
No
Modified estimated time to complete form from 30 minutes to 1 hour. Removed third party disclosure costs as inadvertently entered previously.

$1,459
No
    Yes
    Yes
No
No
No
No
Christina Baptista 703 305-0992 christina.baptista@usdoj.gov

  No

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.
12/07/2021


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