View Information Collection (IC)

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 500.75 29 CFR 500.76

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	WH-516 English	Worker Information-Terms and Conditions of Employment	WH-516 1-28-14.pdf	http://www.dol.gov/whd/forms/wh516.pdf	Yes	No	Fillable Printable
Form	WH-516 Spanish	Informacion Sobre el Obrero-Terminos y Condiciones de Empleo	WH-516_Spanish 1-28-14.pdf	http://www.dol.gov/whd/forms/WH-516_Spanish.pdf	Yes	No	Fillable Printable
Form	WH-516 Haitian Creole	Lwa sou Pwoteksyon Travaye Agrikol Migran epi Tanpore	WH-516_HaitianCreole 1-28-14.pdf	http://www.dol.gov/whd/forms/WH516HaitianCreole.pdf	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 107,706	Number of Respondents for Small Entity: 100,000

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	2,685,360	0	0	0	0	2,685,360
Annual IC Time Burden (Hours)	58,280	0	0	158	0	58,122
Annual IC Cost Burden (Dollars)	107,414	0	0	0	0	107,414

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.