Information Collection Request

Workplace Discrimination Complaints

ICR 202305-3060-014 · OMB 3060-1237 · Active

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 3060-1237 can be found here:

Forms and Documents

Document Name	Status
Form FCC Form 5621 Federal Government Form	Modified
Form FCC Form 5622 Individuals or Households Form	Modified
Supporting Statement Forms 5621 and 5622 Workplace Discrimination_final version.docx Supporting Statement A	2023-05-26

IC Document Collections

IC ID	Document Title	Status
241980	Federal Government Form	Modified
226756	Individuals or Households Form	Modified

ICR Details

Status	Active
Agency/Subagency	FCC
OMB Control No	3060-1237
Type of Information Collection	Extension without change of a currently approved collection
Previous ICR Reference No	202211-3060-023
Agency Tracking No	OWD
Date Submitted to OIRA	2023-05-30
Requested Expiration Date	1969-12-31