View Information Collection (IC)

View Information Collection (IC)

IC Title:	Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 41 CFR 60-250.61(b) 41 CFR 60-741.61(c) 41 CFR 60-1.23(a) (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
Instruction			cc 4 instructions 19 June 2014 final.docx	http://www.dol.gov/ofccp/regs/compliance/pdf/pdfstart.htm	Yes	No	Printable Only
Form	cc-4, revised 1/2014	Complaint Involving Employment Discrimination by a Federal Contractor or Subcontractor	CC-4 Form Revised 20 June 2014 final.docx	http://www.dol.gov/ofccp/regs/compliance/pdf/English.pdf	Yes	Yes	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title: Complaint Case Files, DOL/ESA-2	FR Citation: 67 FR 16868

Number of Respondents: 747	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	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	747	0	0	145	0	602
Annual IC Time Burden (Hours)	747	0	-169	145	0	771
Annual IC Cost Burden (Dollars)	52	0	0	-231	0	283

Documents for IC

Title	Document	Date Uploaded
Screenshot of OFCCP's Complaint Website	screen shot of webpage for filing complaints.docx	06/20/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.