Information Collection

H-2B Program

IC 204361 under ICR 201510-1205-004 · OMB 1205-0509.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0509 can be found here:

Documents and Forms

Document Name Document Type
Form ETA-9142B H-2B Program Form
ETA Form 9142B Instructions 10.15.15 CLEAN.doc Instruction
ETA-9142B H-2B Application for Temporary Employment Certification ETA Form 9142B Screenshots.pdf Form
ETA-9142B H-2B Application for Temporary Employment Certification ETA Form 9142B CLEAN .doc Form
ETA-9142B - Append H-2B Appendix B ETA Form 9142B Appendix B CLEAN.doc Form
ETA Form 9142B TRACKCHANGES.doc Form ETA-9142B Track Changes IC Document
ETA Form 9142B Appendix B TRACKCHANGES.doc Form ETA-9142B Appendix B Track Changes IC Document
ETA Form 9142B Instructions 10.15.15 TRACKCHANGES.doc Form ETA-9142B Instructions IC Document

Information Collection (IC) Details

View Information Collection (IC)

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

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 8 CFR 214.2(h)(6)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA-9142B	H-2B Application for Temporary Employment Certification	ETA Form 9142B Screenshots.pdf	Yes	Yes	Fillable Fileable
Form	ETA-9142B	H-2B Application for Temporary Employment Certification	ETA Form 9142B CLEAN .doc	Yes	Yes	Fillable Fileable
Form	ETA-9142B - Appendix B	H-2B Appendix B	ETA Form 9142B Appendix B CLEAN.doc	Yes	Yes	Fillable Fileable
Instruction			ETA Form 9142B Instructions 10.15.15 CLEAN.doc	Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,505	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: 90 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	170,669	-4,257	174,926
Annual IC Time Burden (Hours)	42,039	808	41,231
Annual IC Cost Burden (Dollars)	351,800	0	351,800

Documents for IC

Title	Document	Date Uploaded
Form ETA-9142B Track Changes	ETA Form 9142B TRACKCHANGES.doc	10/19/2015
Form ETA-9142B Appendix B Track Changes	ETA Form 9142B Appendix B TRACKCHANGES.doc	10/19/2015
Form ETA-9142B Instructions	ETA Form 9142B Instructions 10.15.15 TRACKCHANGES.doc	10/19/2015

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