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:
3060-1237
ICR Reference No:
202206-3060-015
Status:
Historical Active
Previous ICR Reference No:
202004-3060-043
Agency/Subagency:
FCC
Agency Tracking No:
OWD
Title:
Workplace Discrimination Complaints
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Delegated
OIRA Conclusion Action:
Approved without change
Conclusion Date:
06/21/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
06/21/2022
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2023
05/31/2023
05/31/2023
Responses
23
0
23
Time Burden (Hours)
67
0
67
Cost Burden (Dollars)
8,000
0
8,000
Abstract:
The Commission is requesting approval for non-substantive changes to the forms associated with the FCC’s Informal Complaint of Discrimination (FCC Form 5621) and the FCC’s Formal Complaint of Discrimination (FCC Form 5622). As part of the development of an online application for its informal and formal complaint process, the FCC discovered that there were inconsistencies in the Privacy Act Statements included on these forms and the FCC’s online application for submitting complaints which could prove confusing to complainants, and could potentially provide insufficient information about the Privacy Act routine uses and whether submitting information is mandatory or voluntary. To remedy this issue, the FCC has revised its Privacy Act Statements on both forms. The updates to this collection will cause no change in the burden estimates or reporting and record keeping requirements that the Commission submitted (and which OMB subsequently approved) in 2017 and extended in 2020. FCC employees, former employees and applicants for employment who believe they were denied equal employment opportunity based on race, color, religion, gender, national origin, age, physical or mental disability, genetic information and/or reprisal will complete FCC-5621 and FCC-5622.
Authorizing Statute(s):
US Code:
42 USC 2000ff-6(f)
US Code:
29 USC 206(d)
US Code:
29 USC 6333a
US Code:
29 USC 791
US Code:
29 USC 794a
US Code:
42 USC 2000e-16
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:
85 FR 16625
03/24/2020
30-day Notice:
Federal Register Citation:
Citation Date:
85 FR 16625
03/24/2020
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
Federal Government
FCC Form 5621
INFORMAL COMPLAINT of DISCRIMINATION
Individuals or Households
FCC Form 5622
FORMAL COMPLAINT OF DISCRIMINATION
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
23
23
0
0
0
0
Annual Time Burden (Hours)
67
67
0
0
0
0
Annual Cost Burden (Dollars)
8,000
8,000
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:
The Commission is reporting an adjustment to this information collection. The total number of respondents and total annual responses decreased by 3, the total annual burden hours decreased by 24 hours and the total annual costs decreased by $7,000. These decreases are based on the most currently available data to the Commission.
Annual Cost to Federal Government:
$226,961
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:
Cynthia Bryant 202 418-8165 cynthia.bryant@fcc.gov
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:
06/21/2022
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