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Federal forms, ICRs, and supporting documents

Information Collection Request

Records to be kept by Employers - Fair Labor Standards Act

ICR 201205-1235-002 · OMB 1235-0018 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
207305 Minimum Age Standards - Parental Consent New
192422 Application for Authorized Basic Rate Modified
192421 Records When Claiming Partial Overtime Exemption for Remedial Education Unchanged
192420 Requirements of a Bona Fide Thrift or Savings Plan and a Bona Fide Profit-Sharing Plan or Trust Modified
192419 Recording Schools With WECEP Students Unchanged
192418 WECEP Written Training Agreement Unchanged
192417 Work Experience and Career Exploration Program (WECEP) Application Unchanged
192416 Waiver of Child Labor Provisions for Agricultural Employment of 10 and 11 Year Old Minors in Hand Harvesting of Short Season Crops Unchanged
192415 Application for Federal Certificate of Age Modified
192414 General FLSA Records (Public Sector) Modified
178590 Written Agreements to Claim the Agricultural Student Learner Exemption to Youth Employment Resrtictions Modified
178589 Written Agrrements to Claim the Non-Agricultural Student Learner Exemption to Youth Employment Resrtictions Unchanged
178588 Records on State/Local Government Employees Receiving Compensatory Time Modified
178587 Records on Workers with Disabilities and Patient Workers Paid Sub-Minimum Wages Modified
178586 Records on Messengers and Student Learners Paid Sub-Minimum Wages Unchanged
178585 Records on Full-Time Students Paid Sub-Minimum Wages Unchanged
178584 Records on Certain Agricultural Employees (Employees) Modified
178520 Records on Certain Agricultural Employees (Employers) Unchanged
178518 Records on Tipped Employees Unchanged
178515 Records When Paying Overtime on an "Applicable " or "Authorized Basic" Rate Unchanged
178513 Records for Overtime Payments Based on Trip Rate Plans Unchanged
178510 Petitions for Review and Reconsideration Unchanged
13628 General FLSA Records (Private Sector) Modified
ICR Details
1235-0018 201205-1235-002
Historical Inactive 201004-1235-001
DOL/WHD
Records to be kept by Employers - Fair Labor Standards Act
Revision of a currently approved collection   No
Regular
Preapproved 09/18/2013
Retrieve Notice of Action (NOA) 02/07/2013
  Inventory as of this Action Requested Previously Approved
09/30/2016 36 Months From Approved 10/31/2013
40,998,533 0 39,462,547
1,250,164 0 853,924
0 0 0
Employers respond to these information collections to document compliance with the Fair Labor Standards Act (FLSA), 29 U.S.C. 201, et seq.
US Code: 29 USC 207(e)(3) Name of Law: Fair Labor Standards Act
   US Code: 29 USC 207(e)(8) Name of Law: Fair Labor Standards Act
   US Code: 29 USC 207(q) Name of Law: Fair Labor Standards Act
   US Code: 29 USC 211(c) Name of Law: Fair Labor Standards Act
   US Code: 29 USC 213(c) Name of Law: Fair Labor Standards Act
   US Code: 29 USC 203(l) Name of Law: Fair Labor Standards Act
  
None
1235-AA05 Final or interim final rulemaking
  78 FR 16299 03/14/2013
Yes
23
IC Title Form No. Form Name
Application for Authorized Basic Rate
General FLSA Records (Public Sector)
Records on Certain Agricultural Employees (Employees)
Records on Full-Time Students Paid Sub-Minimum Wages
Records on Messengers and Student Learners Paid Sub-Minimum Wages
Records on Workers with Disabilities and Patient Workers Paid Sub-Minimum Wages
Records on State/Local Government Employees Receiving Compensatory Time
Written Agrrements to Claim the Non-Agricultural Student Learner Exemption to Youth Employment Resrtictions
Written Agreements to Claim the Agricultural Student Learner Exemption to Youth Employment Resrtictions WH-5
Records When Paying Overtime on an "Applicable " or "Authorized Basic" Rate
Petitions for Review and Reconsideration
Records for Overtime Payments Based on Trip Rate Plans
Records on Tipped Employees
Records on Certain Agricultural Employees (Employers)
General FLSA Records (Private Sector)
Application for Federal Certificate of Age WH-14
Waiver of Child Labor Provisions for Agricultural Employment of 10 and 11 Year Old Minors in Hand Harvesting of Short Season Crops
Work Experience and Career Exploration Program (WECEP) Application
WECEP Written Training Agreement
Recording Schools With WECEP Students
Requirements of a Bona Fide Thrift or Savings Plan and a Bona Fide Profit-Sharing Plan or Trust
Records When Claiming Partial Overtime Exemption for Remedial Education
Minimum Age Standards - Parental Consent
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 40,998,533 39,462,547 0 1,535,986 0 0
Annual Time Burden (Hours) 1,250,164 853,924 0 396,240 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Changing Regulations
Yes
Miscellaneous Actions
Regulatory changes increased burden.
$0
No
No
No
No
No
Uncollected
Mary Ziegler 202 693-0517
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/07/2013