Privacy Act Statement. (This form is covered by the Privacy Act of 1974; Public Law 93-579. Authority for requesting the personal data and the uses thereof are given below.) FORM NUMBER / TITLE / DATE. EEOC Form 283, Intake Questionnaire, September, 2007 AUTHORITY. 42 U.S.C. ____2000e-5(b), 29 U.S.C. ___ 211, 29 U.S.C. ___626. PRINCIPAL PURPOSE (S). The purpose of this questionnaire is to solicit information to enable the Commission to avoid the intake of matters not within its jurisdiction. ROUTING USES. Information provided on this form will be used by Commission employees to determine the existence of facts relevant to a decision as to whether the Commission has jurisdiction over potential charges, complaints or allegations of employment discrimination and to provide on this form may be disclosed to other State, local and federal agencies as may be appropriate or necessary to carrying out the Commission's functions. This would include employment practices laws. Information may also be disclosed to charging parties in consideration of or in connection with litigation. WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL FOR NOT PROVIDING INFORMATION. The providing of this information is voluntary but the failure to do so may hamper the Commission's processing of a charge of discrimination. It is not mandatory that this form be used to provide the requested information.