Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Appendix A EEO Report Forms This appendix reproduces the four equal employment opportunity (EEO) reports that collect data relevant to wages and employment, dis- cussed in Chapter 1: ⢠EEO-1, required from private employers with 100 or more employ- ees or 50 or more employees and a federal contract; ⢠EEO-3, required from referral unions, primarily unions with exclu- sive hiring arrangements with an employer; ⢠EEO-4, required from state and local governments; and ⢠EEO-5, required from primary and secondary public school districts. 99
100 COLLECTING COMPENSATION DATA FROM EMPLOYERS A-2
APPENDIX A 101
102 COLLECTING COMPENSATION DATA FROM EMPLOYERS A-4
APPENDIX A 103 A-5
104 COLLECTING COMPENSATION DATA FROM EMPLOYERS EQUAL EMPLOYMENT OPPORTUNITY COMMISSION APPROVED BY OMB STATE AND LOCAL GOVERNMENT INFORMATION (EEOÂ4) 3046Â0008 EXPIRES EXCLUDE SCHOOL SYSTEMS AND EDUCATIONAL INSTITUTIONS 12/31/2005 (Read attached instructions prior to completing this form) DO NOT ALTER INFORMATION PRINTED IN THIS BOX MAIL COMPLETED FORM TO: EEO-4 Reporting Center PO Box 1898 Chicago, IL 60690-1898 A. TYPE OF GOVERNMENT (Check one box only) 1. State 2. County 3. City 4. Township 5. Special District 6. Other (Specify)___________________________________________________________________________ B. IDENTIFICATION 1. NAME OF POLITICAL JURISDICTION (If same as label, skip to Item C) 2. AddressÂÂNumber and Street CITY/TOWN COUNTY STATE/ZIP EEOC USE ONLY A B C. FUNCTION (Check one box to indicate the function(s) for which this form is being submitted. Data should be reported for all departments and agencies in your government covered by the function(s) indicated.  If you cannot supply the data for every agency within the function(s) attach a list showing name and address of agencies whose data are not included.) 1.Financial Administration.  Tax billing and 8. HEALTH. Provision of public health collection, budgeting, purchasing, central services, outÂpatient clinics, visiting nurses, accounting and similar financial administration food and sanitary inspections, mental health, carried on by a treasurer's, auditor's or alcohol rehabilitation service, etc. comptroller's office and 9. HOUSING.  Code enforcement, low rent GENERAL CONTROL.  Duties usually performed by public housing, fair housing ordinance boards of supervisors or commissioners, central enforcement, housing for elderly, housing administration offices and agencies, central rehabilitation, rent control. personnel or planning agencies, all judicial offices and employees (judges, magistrates, bailiffs, etc.) 2. STREETS AND HIGHWAYS.  Maintenance, 10. COMMUNITY DEVELOPMENT.  Planning, repair, construction and administration of streets, zoning, land development, open space, alleys, sidewalks, roads, highways and bridges. beautification, preservation. 3. PUBLIC WELFARE. Maintenance of homes and 11. CORRECTIONS.  Jails, reformatories, other institutions for the needy; administration of detention homes, halfÂway houses, prisons, public assistance. (Hospitals and sanatoriums parole and probation activities should be reported as item7.) 4. POLICE PROTECTION.  Duties of a police 12. UTILITIES AND TRANSPORTATION. department sheriff's, constable's, coroner's office, Includes water supply, electric power, transit, etc., including technical and clerical employees gas, airports, water transportation and engaged in police activities. terminals. 13. SANITATION AND SEWAGE.  Street 5. FIRE PROTECTION.  Duties of the uniformed fire cleaning, garbage and refuse collection and force and clerical employees.  (Report any forest disposal.  Provision, maintenance and fire protection activities as item 6.) operation of sanitary and storm sewer systems and sewage disposal plants. 6. NATURAL RESOURCES. Agriculture, forestry, forest fire protection, irrigation drainage, flood control, etc., and 14. EMPLOYMENT SECURITY STATE PARKS AND RECREATION.  Provision, maintenance GOVERNMENTS ONLY and operation of parks, playgrounds, swimming pools, auditoriums, museums, marinas, zoos, etc. 7. HOSPITALS AND SANATORIUMS. Operation and 15. OTHER (Specify on Page Four) maintenance of institutions for inpatient medical care. EEOC FORM 164 FEB 97 (Previous Editions are Obsolete)       PAGE 1Â
APPENDIX A 105 D. EMPLOYMENT DATA AS OF JUNE 30 (Do not include elected/appointed officials.  Blanks will be counted as zero) 1. FULLÂTIME EMPLOYEES (Temporary employees are not included) MALE FEMALE AMERICAN AMERICAN NONÂHISPANIC ANNUAL ASIAN INDIAN NONÂHISPANIC ASIAN INDIAN ORIGIN OR OR SALARY OR ORIGIN OR TOTAL PACIFIC ALASKAN PACIFIC ALASKAN (In thousands 000) (COLUMNS BÂK) WHITE Black HISPANIC ISLANDER NATIVE White Black HISPANIC ISLANDER NATIVE A B C D E F G H I J K 1. $0.1Â15.9 2. 16.0Â19.9 3. 20.0Â24.9 4. 25.0Â32.9 5. 33.0Â42.9 6. 43.0Â54.9 7. 55.0Â69.9 8. 70.0 PLUS 9. $0.1Â15.9 10. 16.0Â19.9 11. 20.0Â24.9 12. 25.0Â32.9 13. 33.0Â42.9 14. 43.0Â54.9 15. 55.0Â69.9 16. 70.0 PLUS 17. $0.1Â15.9 18. 16.0Â19.9 19. 20.0Â24.9 20. 25.0Â32.9 21. 33.0Â42.9 22. 43.0Â54.9 23. 55.0Â69.9 24. 70.0 PLUS 25. $0.1Â15.9 26. 16.0Â19.9 27. 20.0Â24.9 28. 25.0Â32.9 29. 33.0Â42.9 30. 43.0Â54.9 31. 55.0Â69.9 32. 70.0 PLUS 33. $0.1Â15.9 34. 16.0Â19.9 35. 20.0Â24.9 36. 25.0Â32.9 37. 33.0Â42.9 38. 43.0Â54.9 39. 55.0Â69.9 40. 70.0 PLUS 41. $0.1Â15.9 42. 16.0Â19.9 43. 20.0Â24.9 44. 25.0Â32.9 45. 33.0Â42.9 46. 43.0Â54.9 47. 55.0Â69.9 48. 70.0 PLUS EEEEOC FORM 164, FEB 97 (Previous Editions are Obsolete)              PAGE 2
106 COLLECTING COMPENSATION DATA FROM EMPLOYERS D. EMPLOYMENT DATA AS OF JUNE 30 (Cont.) (Do not include elected/appointed officials.  Blanks will be counted as zero) 1. FULLÂTIME EMPLOYEES (Temporary employees are not included) MALE FEMALE NONÂHISPANIC NONÂHISPANIC AMERICAN AMERICAN ORIGIN ASIAN ORIGIN ASIAN ANNUAL INDIAN INDIAN SALARY TOTAL OR OR OR OR (In thousands (COLUMNS B PACIFIC ALASKAN PACIFIC ALASKAN 000) K) WHITE Black HISPANIC ISLANDER NATIVE White Black HISPANIC ISLANDER NATIVE A B C D E F G H I J K 49. $0.1Â15.9 50. 16.0Â19.9 51. 20.0Â24.9 52. 25.0Â32.9 53. 33.0Â42.9 54. 43.0Â54.9 55. 55.0Â69.9 56. 70.0 PLUS 57. $0.1Â15.9 58. 16.0Â19.9 59. 20.0Â24.9 60. 25.0Â32.9 61. 33.0Â42.9 62. 43.0Â54.9 63. 55.0Â69.9 64. 70.0 PLUS 65. TOTAL FULL TIME (LINES 1 â 64) 2. OTHER THAN FULLÂTIME EMPLOYEES (Including temporary employees 66. OFFICIALS/ADMIN 67. PROFESSIONALS 68. TECHNICIANS 69. PROTECTIVE SERVICE 70. PARAÂPROFESSIONAL 71. ADMIN. SUPPORT 72. SKILLED CRAFT 73. SERVICE/MAINTENANCE 74. TOTAL OTHER THAN FULL TIME (LINES 66 â 73) 3. NEW HIRES DURING FISCAL YEAR Â Permanent full time only JULY 1 â JUNE 30 75. OFFICIALS/ADMIN 76. PROFESSIONALS 77. TECHNICIANS 78. PROTECTIVE SERVICE 79. PARAÂPROFESSIONAL 80. ADMIN. SUPPORT 81. SKILLED CRAFT 82. SERVICE/MAINTENANCE 83. TOTAL NEW HIRES (LINES 75 â 82) EEEEOC FORM 164, FEB 97 (Previous Editions are Obsolete)              PAGE 3
APPENDIX A 107 REMARKS (List National Crime Information Center (NCIC) number assigned to any Criminal Justice Agencies whose data are included in this report) ***LIST AGENCIES INCLUDED ON THIS FORM*** CERTIFICATION.  I certify that the information given in this report is correct and true to the best of my knowledge and was reported in accordance with accompanying instructions. (Willfully false statements on this report are punishable by law, US Code, Title 18, Section 1001.) NAME OF PERSON TO CONTACT REGARDING THIS FORM TITLE ADDRESS (Number and Street, City, State, Zip Code) TELEPHONE NUMBER extension: FAX NUMBER DATE TYPED NAME/TITLE OF AUTHORIZED OFFICIAL SIGNATURE EÂMAIL EEOC  FORM 164, FEB 97 (Previous Editions Obsolete)               PAGE 4
108 COLLECTING COMPENSATION DATA FROM EMPLOYERS EQUAL EMPLOYMENT OPPORTUNITY COMMISSION FORM APPROVED BY OMB ELEMENTARY-SECONDARY STAFF INFORMATION (EEO-5) NO. 3046-0003 APPROVAL EXPIRES Public school systems This is a joint requirement of the EEOC and the Office for Civil Rights, U.S. Department of Education and the U.S. Department of Justice. DO NOT ALTER INFORMATION PRINTED IN THIS BOX. NOTE: ALL EMPLOYEES IN YOUR SCHOOL DISTRICT MUST BE INCLUDED ON THIS FORM. Additional Copies of this form may be obtained from the address below. Send your full report to: PART I. IDENTIFICATION A. TYPE OF AGENCY WHICH OPERATES THE REPORTING SCHOOL SYSTEM ⮠Local Public School ⯠Special Regional Agency ⮠State Education Agency ⮠Other (Specify) ____________________________________ B. SCHOOLS SYSTEMS IDENTIFICATION (OMIT IS SAME AS LABEL) NAME STREET AND NO. OR POST OFFICE BOX CITY/TOWN COUNTY STATE ZIP C. GENERAL STATISTICS NUMBER OF SCHOOLS OPERATED NUMBER OF ANNEXES OPERATED OCTOBER 1ST ENROLLMENT D. REMARKS EEOC FORM 168A Page 1
APPENDIX A 109 DO NOT INCLUDE ELECTED/APPOINTED OFFICIALS (SEE DEFINITION IN PART II. Staff Statistics of (DATE) ________________________ APPENDIX) DISTRICT NAME: _______________________________________ A. FULL-TIME STAFF Race/Ethnicity Activity Assignment Hispanic or Non -Hispanic or Latino Classification Latino Total Male Female Col A-N Black or African or Alaska Native American Indian Native Hawaiian American Indian or Other Pacific Two or more Native Hawaiian Black or African Two or more or Other Pacific American or Alaska Islander Female Native White White Asian Asian races Male races American Islander A B C D E F G H I J K L M N O 1. Officials, Administrators, Managers 2. Principals 3. Assistant Principals, Teaching 4. Assistant Principals, Non-teaching 5. Elementary Classroom Teachers 6. Secondary Classroom Teachers 7. Other Classroom Teachers 8. Guidance 9. Psychological 10. Librarians/ Audiovisual Staff 11. Consultants & Supervisors of Instruction 12. Other Professional Staff 13. Teachers Aides 14. Technicians 15. Administrative Support Workers 16. Service Workers 17. Skilled Crafts 18. Laborers and Helpers 19. TOTALS (1-18)
110 COLLECTING COMPENSATION DATA FROM EMPLOYERS B. PART-TIME STAFF Activity Race/Ethnicity Assignment Classification Hispanic Non -Hispanic or Latino or Latino Male Female Black or African or Alaska Native American Indian Native Hawaiian American Indian Native Hawaiian Black or African or Other Pacific or Other Pacific Two or more Two or more American or Alaska Islander Female Native White White Asian Asian races Male races American Islander 20. Professional Instructional 21. All Other 22. TOTALS (20-21) C. NEW HIRES FULL-TIME (JULY THRU SEPT. OF THE SURVEY YEAR) 23. Officials, Administrators, Managers 24. Principals/Assistant Principals 25. Classroom Teachers 26. Other Professional Staff 27. Nonprofessional Staff 28. TOTALS (23-27) CERTIFICATION: I certify that the information given in this report is correct and true to the best of my knowledge and was prepared in accordance with accompanying instructions. Willfully false statements on this report are punishable by law, U.S. Code, Title 18, Section 1001. Date Phone: Typed Name/Title of Person Responsible for Report Signature Fax: Email: EEOC FORM 168A PREVIOUS EDITIONS ARE OBSOLETE