View Information Collection Request (ICR) Package
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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:
3150-0255
ICR Reference No:
202205-3150-001
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
NRC
Agency Tracking No:
Title:
NRC Form 646, "Formal Discrimination Complaint"
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
01/04/2023
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/27/2022
Terms of Clearance:
In accordance with 5 CFR 1320, this information collection is approved.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2026
36 Months From Approved
Responses
30
0
0
Time Burden (Hours)
30
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
As set forth under 29 CFR 1614, the EEO complaint process prescribes that when an aggrieved individual believes that they have been discriminated against on the basis of their race, color, religion, sex (including sexual orientation, gender identity and expressions, and pregnancy), national origin, age, disability, genetic information (including family medical history), marital status, parental status, political affiliation, military service, and reprisal and seeks EEO counseling, the assigned EEO Counselor will conduct the pre-complaint (Informal) with the intentions of resolving the complaint within the Agency. At the conclusion of pre-complaint (Informal) process and if resolution was unsuccessful, the EEO Counselor during the final interview with the aggrieved person must discuss what occurred during the counseling process and provide the aggrieved with information to move the matter forward. Pursuant to 29 CFR § 1614.105(c), if the aggrieved individual decides to file a Formal complaint (i.e., NRC Form 646), the EEO Counselor must submit a written report (i.e., EEO Counselors Report) within fifteen (15) calendar days to the SBCR Director or designated official that will contain relevant information about the aggrieved individual, jurisdiction, claims, bases, Responding Management Officials (RMO), witnesses, requested remedies, and the EEO Counselor's checklist. Once received by the NRC, an authorized NRC representative will place the completed NRC Form 646 in a secure folder created specifically for the aggrieved individual within an automated tracking system.
Authorizing Statute(s):
PL:
Pub.L. 88 - 352 703
Name of Law: Title VII of the Civil Rights Act of 1964, as amended
PL:
Pub.L. 93 - 112 501
Name of Law: Rehabilitation Act of 1973
PL:
Pub.L. 90 - 202 621
Name of Law: Age Discrimination in Employment Act of 1967
PL:
Pub.L. 88 - 38 206
Name of Law: Equal Pay Act of 1963
PL:
Pub.L. 110 - 233 201
Name of Law: Genetic Nondiscrimination Act of 2008
PL:
Pub.L. 107 - 174 301
Name of Law: Notification and Federal Employee Antidiscrimination and Retaliation Act of 2002
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:
87 FR 8060
02/11/2022
30-day Notice:
Federal Register Citation:
Citation Date:
87 FR 32196
05/27/2022
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
NRC Form 646, "Formal Discrimination Complaint"
NRC Form 646
Formal Discrimination Complaint
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
30
0
0
30
0
0
Annual Time Burden (Hours)
30
0
0
30
0
0
Annual Cost Burden (Dollars)
0
0
0
0
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:
This is a request for a new OMB clearance. The NRC Form 646 serves as the required written request to further pursue unresolved claim(s) of unlawful discrimination through the formal complaint procedure in accordance with 29 C.F.R. §1614.105 and MD 110. The information collected enables the Agency to properly identify the claim(s) raised by the complainant and determine if such claim(s) can legally be accepted for investigation or dismissed in accordance with 29 C.F.R. §1614.106 and 29 C.F.R. §1614.107.
Annual Cost to Federal Government:
$2,880
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
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?
No
Agency Contact:
Erin Deeds 301 415-7000
Common Form ICR:
No
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:
05/27/2022
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