PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Individual Complaint of Employment Discrimination
Modified
10
30
0
Form
DOT Form 1050-1
EEO COUNSELOR CHECKLIST
Form
DOT Form 1050-2
Mediation Intake.doc
Form
DOT Form 1050-3
Agreement to Mediate
Form
DOT Form 1050-4
Exit Survey for Mediation Participants
Form
DOT Form 1050-6
NOTICE OF RIGHT TO FILE A DISCRIMINATION COMPLAINT
Form
DOT Form 1050-5
Extension of EEO Counseling
Form
DOT Form 1050-7
Notice of Rights and Responsibilities
Form and Instruction
DOT Form 1050-8
Individual Complaint of Employment
Form
DOT Form 1050-9
DESIGNATION OF REPRESENTATIVE FORM
Form
DOT Form 1050-10
Final Agency Decision Request Form
Form
DOT Form 1050-11
WAIVER OF RIGHT TO ANONYMITY
Form
DOT Form 1050-12
Request for Mediation
Total burden requested under this ICR:
10
30
0
To view an IC, click on IC Title
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