Information Collection

Form ETA-9142-B-CAA-3

IC 235962 under ICR 201905-1205-002 · OMB 1205-0535.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0535 can be found here:

Documents and Forms

Document Name Document Type
Form Form ETA9142-B-CAA Form ETA-9142-B-CAA-3 Form
508 Form ETA 9142-B-CAA-3_General Instructions -DHS-OGC 4.17 DOL (1).pdf Instruction
Form ETA9142-B-CAA Attestation for Employers Seeking to Employ H-2B Nonimmi 508 Form ETA 9142-B-CAA-3_G-DHS-OGC 4-17 DOL.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Form ETA-9142-B-CAA-3	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 655 8 CFR 214

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Form ETA9142-B-CAA-3	Attestation for Employers Seeking to Employ H-2B Nonimmigrant Workers Under Section 105 of Division H of the Consolidated Appropriations Act, 2019 Public Law 116-6 (February 15, 2019)	508 Form ETA 9142-B-CAA-3_G-DHS-OGC 4-17 DOL.pdf		Yes	No	Fillable Printable
Instruction			508 Form ETA 9142-B-CAA-3_General Instructions -DHS-OGC 4.17 DOL (1).pdf		Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,776	Number of Respondents for Small Entity: 3,700

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	3,776	3,776
Annual IC Time Burden (Hours)	21,712	21,712
Annual IC Cost Burden (Dollars)	0	0

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.