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30-Day Notice of Proposed Information Collection: Complaint of Discrimination

This document has a comment period that ends in 16 days. (06/07/2019) Submit a formal comment

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Notice of request for public comment and submission to OMB of proposed collection of information.


The Department of State has submitted the information collection described below to the Office of Management and Budget (OMB) for approval. In accordance with the Paperwork Reduction Act of 1995 we are requesting comments on this collection from all interested individuals and organizations. The purpose of this Notice is to allow 30 days for public comment.


Submit comments directly to the Office of Management and Budget (OMB) up to June 7, 2019.


Direct comments to the Department of State Desk Officer in the Office of Information and Regulatory Affairs at the Office of Management and Budget (OMB). You may submit comments by the following methods:

  • Email: You must include the DS form number, information collection title, and the OMB control number in the subject line of your message.
  • Fax: 202-395-5806. Attention: Desk Officer for Department of State. You must include the information collection title (Request for Commodity Jurisdiction Determination), form number (DS-4282), and the OMB control number (1405-0220) in all correspondence.
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Direct requests for additional information regarding the collection listed in this notice, including requests for copies of the proposed collection instrument and supporting documents, to Alice Kottmyer, who may be reached at, 202-647-2318.

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  • Title of Information Collection: Complaint of Discrimination Under Section 504, Section 508 or Title VI.
  • OMB Control Number: 1405-0220.
  • Type of Request: Revision of a Currently Approved Collection.
  • Originating Office: Office of Civil Rights, S/OCR.
  • Form Number: DS-4282.
  • Respondents: This information collection is used by any Federal employee or member of the public who wishes to submit a complaint of discrimination under Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d); or Sections 504 or 508 of the Rehabilitation Act of 1973 (29 U.S.C. 794 and 794d).
  • Estimated Number of Respondents: 10.
  • Estimated Number of Responses: 10.
  • Average Time Per Response: 1 Hour.
  • Total Estimated Burden Time: 10 Hours.
  • Frequency: On occasion.
  • Obligation to Respond: Voluntary.

We are soliciting public comments to permit the Department to:

  • Evaluate whether the proposed information collection is necessary for the proper functions of the Department.
  • Evaluate the accuracy of our estimate of the time and cost burden for this proposed collection, including the validity of the methodology and assumptions used.
  • Enhance the quality, utility, and clarity of the information to be collected.
  • Minimize the reporting burden on those who are to respond, including the use of automated collection techniques or other forms of information technology.

Please note that comments submitted in response to this Notice are public record. Before including any detailed personal information, you should be aware that your comments as submitted, including your personal information, will be available for public review.

Abstract of Proposed Collection

The form created by this information collection (DS-4282) will be used to present complaints of discrimination under Title VI of the Civil Rights Act of 1964; or Sections 504 or 508 of the Rehabilitation Act of 1973 (29 U.S.C. 794 and 794d).


The form can be downloaded from​Forms/​ds4282.PDF. After completion, the form may be submitted by email, mail, fax, or hand-delivery.

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Dated: April 26, 2019.

Gregory B. Smith,


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[FR Doc. 2019-09462 Filed 5-7-19; 8:45 am]