Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
3046-0046
ICR Reference No:
201310-3046-002
Status:
Historical Active
Previous ICR Reference No:
201205-3046-001
Agency/Subagency:
EEOC
Agency Tracking No:
Title:
Applicant Background Questionnaire
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
Yes
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
02/10/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/01/2013
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
02/28/2017
36 Months From Approved
02/28/2014
Responses
5,800
0
26,854,281
Time Burden (Hours)
290
0
1,342,714
Cost Burden (Dollars)
0
0
0
Abstract:
The Demographic Information on Applicants form is designed to enable federal agencies to evaluate their employment practices by collecting and analyzing data on the race, national origin, sex and disability status of applicants for employment.
Authorizing Statute(s):
US Code:
29 USC 791
Name of Law: Rehabilitation Act 1973
US Code:
42 USC 2000e
Name of Law: Title VII of the Civil Rights Act of 1964
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
78 FR 11175
02/15/2013
30-day Notice:
Federal Register Citation:
Citation Date:
78 FR 56696
09/13/2013
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Applicant Background Questionnaire
3046-0046
Demographic Information on Applicants
ICR Summary of Burden
Total Approved
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
5,800
26,854,281
0
-26,848,481
0
0
Annual Time Burden (Hours)
290
1,342,714
0
-1,342,424
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The Applicant Background Questionnaire was not previously a common form. Now that we intend to host it as a common form, EEOC must only include an estimate of its own burden associated with the IC.
Annual Cost to Federal Government:
$0
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Dexter Brooks 202 663-4511
Common Form ICR:
Yes
OIRA authorizes any Agency to begin using a Common Form associated with this ICR automatically after 5 calendar days from the date the agency's RCF including the common form was received in OIRA.
Description/Changes for Common Form Usage:
The Commission is charged with reviewing and approving federal agencies' plans to affirmatively address potential discrimination. As a part of this obligation, the Commission has established systems to monitor compliance by requiring agencies to evaluate their recruitment through the collection and analysis of applicant data on the race, national origin, sex, and disability status. This common form will allow federal agencies to consistently collect the required information.
Approved RCFs using this ICR
Agency/Sub Agency
RCF ID
RCF Title
RCF Status
IC Title
DOI/OEO
201504-1091-001CF
DOI Use of Demographic Information on Applicants Form
Historical Active
Applicant Background Questionnaire
DOL/DM
201403-1225-004CF
Applicant Background Questionnaire
Historical Active
Applicant Background Questionnaire
DOL/DM
201403-1225-005CF
Applicant Background Questionnaire
Historical Active
Applicant Background Questionnaire
DOC/CENSUS
201702-0607-001CF
Census Bureau Request to Use the Demographic Information on Applicants for Federal Employment” (Form 3046-0046)
Historical Active
Applicant Background Questionnaire
DOL/DM
201611-1225-012CF
Applicant Background Questionnaire
Historical Active
Applicant Background Questionnaire
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
11/01/2013
An official website of the United States government
The .gov means it's official.
The site is secure.
