View Information Collection (IC)

View Information Collection (IC)

IC Title:	Prevailing Wage Determination	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 655.10 8 CFR 214.2(h)(6) 20 CFR 655.731 20 CFR 650.40

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA-9141	Application for Prevailing Wage Determination	ETA Form 9141.pdf		Yes	Yes	Fillable Fileable
Instruction			ETA Form 9141 Instructions.pdf		Yes	No	Printable Only
Form	Form ETA-9141 – Appendix A	Application for Prevailing Wage Determination Form ETA-9141 – Appendix A, Request for Additional Worksite(s)	CLEAN - 6. Form ETA-9141 App. A.docx		Yes	Yes	Fillable Fileable
Form	ETA-9141	Application for Prevailing Wage Determination	NEW - Form ETA-9141.docx		Yes	Yes	Fillable Fileable
Instruction			New - Form ETA-9141 General Instructions.docx		Yes	No	Printable Only
Form	Form ETA-9141 - Appendix A	Form ETA-9141 Appendix A, Request for Additional Worksite(s)	New - Form ETA-9141 Appendix A.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 88,599	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 99 %

	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	320,850	0	0	-681,742	0	1,002,592
Annual IC Time Burden (Hours)	143,194	0	0	-305,187	0	448,381
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
FORM ETA-9141 - Track Changes	RECONCILED - TRACKED - 5. Form ETA-9141 05.30.19.docx	05/30/2019
Form ETA-9141- General Instructions - Track Changes	RECONCILED - TRACKED - 7. Form ETA-9141 General Instructions 05.30.19.docx	05/30/2019
Form ETA-9141 - Appendix A - Request for Additional Worksites	Form ETA-9141 Appendix A tracked 05.30.19.docx	05/30/2019

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