View Information Collection Request (ICR) Package

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: 2700-0163	ICR Reference No: 201508-2700-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: NASA	Agency Tracking No:
Title: NASA Complaint of Discrimination Form 1355
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/11/2016
	Date Received in OIRA: 09/14/2015
Terms of Clearance: This collection is approved based on the revised materials provided by the Agency. NASA must report this collection as a violation in this year's information collection budget (ICB).

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2018	36 Months From Approved
Responses	60	0	0
Time Burden (Hours)	30	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	60	60
Annual Time Burden (Hours)	30	30
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden increase occurred because has established a single NASA form to enable individuals to formally report a complaint of discrimination. This form will be used by all NASA Centers.

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