EEO-1 Component 1 Data Collection Form

Collects workforce headcount by job category, race or ethnicity, and sex for the EEOC annual EEO-1 Component 1 report for covered employers.

Reporting Context

• Reporting Year
  Enter the calendar year for the EEO-1 Component 1 report.
• Reporting Period End Date
  Use the official snapshot date for the reporting period.
• Submitter Name
  Name of the person preparing or certifying the submission.
• Submitter Email
  Work email for follow-up questions and approval routing.

Employer and Establishment Information

• Employer Legal Name
  Legal entity name used for the EEO-1 filing.
• Employer EIN Last 4 Digits
  Enter only the last 4 digits of the EIN for identification and audit trail purposes.
• Reporting Scope
• Primary Worksite State
  Required only if the report is tied to a single establishment.

EEO-1 Job Category Headcount

• 1. Executive/Senior Officials and Managers
• 2. First/Mid Officials and Managers
• 3. Professionals
• 4. Technicians
• 5. Sales Workers
• 6. Administrative Support Workers
• 7. Craft Workers
• 8. Operatives
• 9. Laborers and Helpers
• 10. Service Workers

Race, Ethnicity, and Sex Headcount

• Race or Ethnicity Reporting Method
• Sex Reporting Method
• Headcount by Job Category, Race/Ethnicity, and Sex
  Enter one row per applicable job category. Use numeric counts only. Do not include employee names or other direct identifiers.

Data Quality and Certification

• Data Quality Review Completed
  Confirm that totals were reviewed for completeness, accuracy, and consistency before submission.
• Known Data Limitations
  Describe any data gaps, reconciliation issues, or assumptions used. Leave blank if none.
• Certification Statement
  I certify that the information provided is complete and accurate to the best of my knowledge and was prepared using the minimum necessary workforce data for compliance reporting.
• Certifier Signature
  Signature of the authorized submitter or certifier.