OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Disclosures to Workers Under the Migrant and Seasonal Agricultural Worker Protection Act

ICR 201312-1235-001 · OMB 1235-0002 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form WH-521 English and Housing Terms and Conditions for Migrant Agricultural Workers Form Modified Available
Form WH-501 English Migrant and Seasonal Agricultural Worker Protection Wage Statement Form Modified Available
Form WH-516 English Worker Information - Terms and Conditions of Employment Form Modified Available
WH-516_Spanish chgs.pdf Supplementary Document Uploaded 2014-04-02 Available
WH-516_HaitianCreole chgs.pdf Supplementary Document Uploaded 2014-04-02 Available
WH-516 chgs.pdf Supplementary Document Uploaded 2014-04-02 Available
wh521 chgs.pdf Supplementary Document Uploaded 2014-04-02 Available
1235-0002ss(201400506).doc Supporting Statement A Uploaded 2014-05-06 Available
1235-0002 FR60day 1-28-14.pdf Supplementary Document Uploaded 2014-04-02 Available
IC Document Collections
IC IDCollectionTypeStatusForm
195676 Housing Terms and Conditions for Migrant Agricultural Workers Form Modified
195675 Migrant and Seasonal Agricultural Worker Protection Wage Statement Form Modified
13905 Worker Information - Terms and Conditions of Employment Form Modified
ICR Details
1235-0002 201312-1235-001
Historical Active 201210-1235-001
DOL/WHD
Disclosures to Workers Under the Migrant and Seasonal Agricultural Worker Protection Act
Revision of a currently approved collection   No
Regular
Approved without change 06/12/2014
Retrieve Notice of Action (NOA) 05/12/2014
  Inventory as of this Action Requested Previously Approved
06/30/2017 36 Months From Approved 06/30/2014
84,206,505 0 84,206,505
1,417,594 0 1,417,436
3,368,260 0 3,368,260
Agricultural employers and associations and farm labor contractors use this information collection to disclose employment terms and conditions, wage statements, and housing terms and conditions to migrant/seasonal agricultural workers, to comply with the Migrant Seasonal Agricultural Worker Protection Act.
US Code: 29 USC 1801, et seq. Name of Law: Migrant and Seasonal Agricultural Worker Protection Act
  
None
Not associated with rulemaking
  79 FR 4508 01/28/2014
79 FR 26997 05/12/2014
No
  Total Approved 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 84,206,505 84,206,505 0 0 0 0
Annual Time Burden (Hours) 1,417,594 1,417,436 0 0 158 0
Annual Cost Burden (Dollars) 3,368,260 3,368,260 0 0 0 0
No
No
The 158 burden hour increase is due to the correction of an inadvertent error in the average response time for each disclosure of terms and conditions of employment used during the prior ICR's clearance.
$62,256
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.
05/12/2014