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OMB Control No: 1190-0018	ICR Reference No: 202604-1190-001
Status: Received in OIRA	Previous ICR Reference No: 202211-1190-001
Agency/Subagency: DOJ/CRT	Agency Tracking No: 1190-0018
Title: Office of Special Counsel for Immigration-Related Unfair Employment Practices Charge Form
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 04/27/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	918	0
Time Burden (Hours)	459	0
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses	918	598	320
Annual Time Burden (Hours)	459	299	160
Annual Cost Burden (Dollars)	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: The estimated change in burden is due to: (1) no longer incurring agency printing costs due to a transition to electronic files, (2) the number of estimated number of respondents, which has been increased from the prior approval, and (3) the decrease in the average hourly rate applied to the collection and processing costs.

Annual Cost to Federal Government: $46,364

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: Jennifer Sultan 202 305-4154

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