Formal Complaint Form

EEO Complaint Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0262 can be found here:

Documents and Forms

Document Name Document Type
Form TD F 63-03.5 Formal Complaint Form Form and Instruction
TD F 63-03.5 Formal Complaint Form Individual Formal Complaint Form 62-03.5 2019.pdf Form and Instruction
TD F 63-03.5 Formal Complaint Form Individual Formal Complaint Form 62-03.5 2019.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Formal Complaint Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1614

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	TD F 63-03.5	Formal Complaint Form	Individual Formal Complaint Form 62-03.5 2019.pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title: Department of the Treasury, Civil Rights, Complaints and Compliance Review Files System of Records Notice	FR Citation: 81 FR 78266

Number of Respondents: 15	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	15	15
Annual IC Time Burden (Hours)	15	15
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.