View Information Collection (IC)
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Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Compliant Information
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
29 CFR 38.70
29 CFR 37.74
29 CFR 38.73
29 CFR 37.73(a)-(d)
29 CFR 38.72
29 CFR 38.74
29 CFR 38.80
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Prototype Form
PRA Attchment 12 - Sample Discrimination Complaint Form (Final_20171030).docx
Yes
No
Paper Only
Form
DL-2014A
Compliant Information Form
PRA Attchment 8-Complaint Information and Privacy Act Form.pdf
http://www.dol.gov/oasam/programs/crc/external-enforc-complaints.htm
Yes
Yes
Fillable Printable
Instruction
Discrimination ComplaintLogInstructions (Final_20171030).docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Labor Rights Management
Privacy Act System of Records
Title:
DOL/OASAM-22
FR Citation:
67 FR 16816
Number of Respondents:
35,099
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
15 %
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
35,099
0
33,259
0
0
1,840
Annual IC Time Burden (Hours)
35,099
0
33,259
0
0
1,840
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Track Changes Complaint Form
PRA Attchment 12 - Sample Discrimination Complaint Form (Tracked_20171030).docx
10/31/2017
Track Changes PRA Attchment 12 - Sample Discrimination Complaint Log Instructions
Discrimination ComplaintLogInstructions (Tracked_20171030).docx
10/31/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.