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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Employment Under Special Certificates of Workers with Disabilities at Special Minimum Wages
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
29 CFR 525.7-.9
29 CFR 525.11-.13
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
Form Website instructions4-1-16.docx
http://www.dol.gov/whd/forms/fts_wh226.htm
Yes
No
Printable Only
Form and Instruction
WH-226
Application for Authority to Employ Workers with Disabilities at Subminimum Wages
WH226 REV 04 04 16 V2.pdf
http://www.dol.gov/whd/forms/fts_wh226.htm
Yes
No
Fillable Printable
Form and Instruction
WH-226A
Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilities at Subminimum Wages
WH226A REV 04 04 16 V3.pdf
http://www.dol.gov/whd/forms/fts_wh226.htm
Yes
No
Fillable Printable
Form and Instruction
WH-226 and WH-226A electronic form
Section 14c Certificate Application electronic
OMB Screenshots wh-226 and wh-226a.pdf
Yes
Yes
Fillable Fileable
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:
3,000
Number of Respondents for Small Entity:
2,800
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
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
7,500
0
0
0
0
7,500
Annual IC Time Burden (Hours)
13,825
0
0
0
0
13,825
Annual IC Cost Burden (Dollars)
2,030
0
0
-1,015
0
3,045
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.