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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:
201702-3046-002
Status:
Historical Active
Previous ICR Reference No:
201310-3046-002
Agency/Subagency:
EEOC
Agency Tracking No:
Title:
Applicant Background Questionnaire
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
Yes
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
05/30/2017
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/02/2017
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2020
36 Months From Approved
05/31/2017
Responses
5,800
0
5,800
Time Burden (Hours)
290
0
290
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:
81 FR 72585
10/20/2016
30-day Notice:
Federal Register Citation:
Citation Date:
82 FR 12220
03/01/2017
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
5,800
0
0
0
0
Annual Time Burden (Hours)
290
290
0
0
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:
No
Burden Reduction Due to:
Short Statement:
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:
Approved RCFs using this ICR
Agency/Sub Agency
RCF ID
RCF Title
RCF Status
IC Title
ED/OCO
202005-1860-001CF
Demographics Information on Applicants
Historical Active
Applicant Background Questionnaire
ED/OCO
202007-1860-001CF
Demographics Information on Applicants
Active
Applicant Background Questionnaire
DOC/CENSUS
201705-0607-002CF
Census Bureau Request to Use the Demographic Information on Applicants for Federal Employment” (Form 3046-0046)
Historical Active
Applicant Background Questionnaire
DOL/DM
201705-1225-015CF
Applicant Background Questionnaire
Active
Applicant Background Questionnaire
DOI/OEO
201705-1091-002CF
DOI Use of Demographic Information on Applicants Form
Active
Applicant Background Questionnaire
ED/OCO
201706-1860-002CF
Demographics Information on Applicants
Historical Active
Applicant Background Questionnaire
TREAS/DO
201901-1505-001CF
Collection of Demographic Information
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:
03/02/2017
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