Information Collection

Application for Prevailing Wage Determination

IC 235476 under ICR 202108-1205-006 · OMB 1205-0534.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0534 can be found here:

Documents and Forms

Document Name Document Type
Form ETA-9141C Application for Prevailing Wage Determination Form
Form ETA-9141C Application for Prevailing Wage Determination Application for Prevailing Wage Determination Form
Form ETA-9141C General Instructions - 1205-0534 (9-3-21).docx Instruction
Form ETA-9141C General Instructions - 1205-0534 (9-3-21).docx Instruction
ETA-9141C Application for Prevailing Wage Determination Form ETA-9141C - 1205-0534 (9-3-21).docx Form
ETA-9141C Application for Prevailing Wage Determination Form ETA-9141C - 1205-0534 (9-3-21).docx Form
Form_ETA_9141C_PWD_CasePrepView Screenshots.docx Form 9141C Screenshots IC Document
Form_ETA_9141C_PWD_CasePrepView Screenshots.docx Form 9141C Screenshots IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Prevailing Wage Determination	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 655

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA-9141C	Application for Prevailing Wage Determination	Form ETA-9141C - 1205-0534 (9-3-21).docx		Yes	Yes	Fillable Fileable
Instruction			Form ETA-9141C General Instructions - 1205-0534 (9-3-21).docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,626	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	16,958	352	16,606
Annual IC Time Burden (Hours)	7,973	168	7,805
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Form 9141C Screenshots	Form_ETA_9141C_PWD_CasePrepView Screenshots.docx	09/08/2021

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].