Information Collection

H-2A Program

IC 186978 under ICR 201207-1205-009 · OMB 1205-0466.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0466 can be found here:

Documents and Forms

Document Name Document Type
Form ETA-9142A H-2A Program Form
ETA Form 9142A Instructions final to OMB.doc Instruction
Burden Screenshots for 9142A and B.doc Other-Screenshot of burden statement
ETA 9144 Certification Letter after merger.doc Other-Certification Letter
ETA-9142A H-2A Application for Temporary Employment Certification ETA Form 9142A.doc Form
ETA-9142A - Append Appendix A ETA Form 9142A Appendix A.doc Form
ETA-9142A H-2A Application for Temporary Employment Certification Screenshots for 9142.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	H-2A Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 655

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA-9142A	H-2A Application for Temporary Employment Certification	ETA Form 9142A.doc	Yes	Yes	Fillable Fileable
Form	ETA-9142A - Appendix A	Appendix A	ETA Form 9142A Appendix A.doc	Yes	Yes	Fillable Fileable
Instruction			ETA Form 9142A Instructions final to OMB.doc	Yes	No	Printable Only
Form	ETA-9142A	H-2A Application for Temporary Employment Certification	Screenshots for 9142.pdf	Yes	Yes	Fillable Fileable
Other-Certification Letter			ETA 9144 Certification Letter after merger.doc	No		Printable Only
Other-Screenshot of burden statement			Burden Screenshots for 9142A and B.doc	Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title: DOL/ETA-15	FR Citation: 75 FR 6884

Number of Respondents: 7,218	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Farms, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	148,217	361	-5,004	152,860
Annual IC Time Burden (Hours)	44,174	90	-4,418	48,502
Annual IC Cost Burden (Dollars)	1,529,370	0	-223,330	1,752,700

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.