Information Collection

Worker Information - Terms and Conditions of Employment

IC 13905 under ICR 202210-1235-003 · OMB 1235-0002.

Documents and Forms

Document Name Document Type
Form WH-516 Worker Information - Terms and Conditions of Employment Form and Instruction
WH-516 Worker Information- Terms and Conditions of Employment WH-516 Revised v2.0 (2022-12-08).docx www.dol.gov/sites/dolgov/files/WHD/legacy/files/wh516.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Worker Information - Terms and Conditions of Employment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 500.76 29 CFR 500.75

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	WH-516	Worker Information- Terms and Conditions of Employment	WH-516 Revised v2.0 (2022-12-08).docx	https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/wh516.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: 94,729	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Farms

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,625,002	-650,001	2,275,003
Annual IC Time Burden (Hours)	45,229	-5,306	50,535
Annual IC Cost Burden (Dollars)	65,000	-26,000	91,000

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.