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Employment Standards Administration

Agency prefix 1215 · ESA · Cabinet Departments · Latest filing 2010-05-20

Agency summary

Agency code: ESA

Government type: Cabinet Departments

Indexed filings: 1262

Latest filing date: 2010-05-20

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Forms

OMB control numbers for Employment Standards Administration
OMB Number Title Latest filing
1215-0209 Notification of Employee Rights Under Federal Labor Laws 2010-05-20
1215-0208 Work-Study Program of the Child Labor Regulations (WSP) Regulations 29 CFR Section 570.35b 2010-05-20
1215-0190 Nondisplacement of Qualified Workers Under Service Contracts 2010-03-19
1215-0140 Requests to Approve Conformed Wage Classifications and Unconventional Fringe Benefit Plans Under the Davis-Bacon and Related Acts and Contract Work Hours and Safety Standards Act 2010-03-12
1215-0188 Labor Organization and Auxiliary Reports 2010-02-02
1215-0205 Form LM-30 Labor Organization Officer and Employee Report 2009-12-22
1215-0207 Carrier's Report of Issuance of Policy 2009-11-19
1215-0194 Pharmacy Billing Requirements 2009-11-17
1215-0193 Claim for Medical Reimbursement Form 2009-11-17
1215-0105 Request for Employment Information 2009-11-17
1215-0078 Representative Fee Request 2009-11-17
1215-0176 Uniform Billing Form (OWCP-04) 2009-10-06
1215-0137 Provider Enrollment Form 2009-10-06
1215-0144 Overpayment Recovery Questionnaire 2009-09-04
1215-0013 Application to Employ Homeworkers; Piece Rate Measurements; and Homeworker Handbooks 2009-09-04
1215-0206 Death Gratuity 2009-08-28
1215-0057 Authorization for Release of Medical Information (Black Lung Benefits) 2009-08-24
1215-0055 Health Insurance Claim Form 2009-08-24
1215-0005 Applications to Employ Special Industrial Homeworkers and Workers with Disabilities 2009-07-27
1215-0171 Application for Approval of a Representative's Fee in Black Lung Claim Proceedings Conducted by the U.S. Department of Labor 2009-06-18
1215-0200 Statement of Recovery Forms 2009-05-18
1215-0161 Rehabilitation Maintenance Certificate 2009-05-18
1215-0160 Regulations Governing the Administration of the Longshore and Harbor Workers' Compensation Act 2009-05-18
1215-0148 Migrant and Seasonal Agricultural Worker Protection Act Wage Statement 2009-05-18
1215-0112 Request for Earnings Information 2009-05-18
1215-0064 Notice of Termination, Suspension, Reduction, or Increase in Benefit Payments 2009-05-18
1215-0037 Application for a Farm Labor Contractor or Farm Labor Contractor Employee Certificate of Registration 2009-05-18
1215-0192 Employment Under Special Certificates of Apprentices, Messengers and Learners (including Student Learners) 2009-02-20
1215-0166 Request to be Selected as Payee 2009-02-20
1215-0149 Davis-Bacon Certified Payroll 2008-12-19
1215-0175 Partial Overtime Exemption for Remedial Education 2008-12-10
1215-0024 Notice of Final Payment or Suspension of Compensation Benefits 2008-12-02
1215-0181 29 C.F.R. Part 825, The Family and Medical Leave Act of 1993 2008-11-17
1215-0121 Work Experience and Career Exploration Programs (29 C.F.R. 570.35a) 2008-11-06
1215-0023 Notice of Controversion of Right to Compensation 2008-10-28
1215-0083 Application for Federal Certificate of Age 2008-10-24
1215-0119 Requirements of a Bona Fide Thrift or Savings Plan (29 C.F.R. Part 547) and Requirements of a Bona Fide Profit-Sharing Plan or Trust (29 C.F.R. Part 549) 2008-10-03
1215-0113 Certificate of Medical Necessity 2008-09-24
1215-0034 Agreement and Undertaking 2008-09-24
1215-0163 Construction Recordkeeping and Reporting 2008-09-22
1215-0022 Payment of Compensation Without Award 2008-09-18
1215-0032 Applications for Authority to Employ Full-Time Students at Subminimum Wages in Retail/Service Establishments/Agriculture/Institutions of Higher Education 2008-09-16
1215-0072 OFCCP Recordkeeping and Reporting Requirements--Supply and Service 2008-08-18
1215-0173 Representative Payee Report, Representative Payee Report, Short Form, Physician's Medical Officer's Statement 2008-08-07
1215-0103 FECA Medical Report Forms, Claim for Compensation 2008-08-07
1215-0170 Application of the Employee Polygraph Protection Act 2008-07-30
1215-0052 Miner's Claim for Benefits Under the Black Lung Benefits Act and Employment History 2008-07-30
1215-0182 Rehabilitation Action Report 2008-05-29
1215-0146 Housing Terms and Conditions For MSPA Workers 2008-05-29
1215-0167 Notice of Recurrence 2008-04-25
1215-0158 Housing Occupancy Certificate--Migrant and Seasonal Agricultural Worker Protection Act 2008-04-25
1215-0154 Claim for Continuance of Compensation 2008-04-25
1215-0090 Claim adjudication process for alleged presence of pneumoconiosis 2008-04-25
1215-0084 Report of Changes That May Affect Your Black Lung Benefits 2008-04-25
1215-0067 Rehabilitation Plan and Award 2008-04-25
1215-0066 Request for Examination and/or Treatment 2008-04-25
1215-0085 Pre-Hearing Statement 2008-02-08
1215-0056 Comparability of Current Work to Coal Mine Employment 2008-01-25
1215-0027 Certification of Funeral Expenses 2008-01-25
1215-0187 Worker Information - Terms and Conditions of Employment 2007-12-21
1215-0151 Request for Information on Earnings, Dual Benefits, Dependents and Third Part Settlements 2007-12-21
1215-0131 OFCCP Complaint Form 2007-11-08
1215-0073 Application for Continuation of Death Benefit for Student 2007-10-26
1215-0046 Report of Construction Contractor's Wage Rates 2007-10-26
1215-0203 EO 13201 - Notice of Employee Rights Concerning Payment of Union Dues or Fees 2007-09-13
1215-0058 Operator Controversion, Operator Response, Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim 2007-08-28
1215-0031 Employer's First Report of Injury or Occupational Disease; Physician's Report on Impairment of Vision; and Employer's Supplementary Report of Accident or Occupational Illness 2007-08-28
1215-0150 Labor Standards for Federal Service Contracts - Regulations 29 CFR, Part 4 2007-07-19
1215-0060 Request for State or Federal Workers' Compensation Information 2007-07-19
1215-0197 Energy Employees Occupational Illness Compensation Program Act Forms (Various) 2007-06-14
1215-0120 29 CFR, Part 575 - Waiver of Child Labor Provisions for Agricultural Employment of 10 and 11 Year Old Minors in Hand Harvesting of Short Season Crops 2007-06-14
1215-0116 Notice of Law Enforcement Officer's Injury or Occupational Disease (CA-721); Notice of Law Enforcement Officer's Death (CA-722) 2007-06-14
1215-0069 Survivor's Form for Benefits 2007-06-14
1215-0204 Securing Financial Obligations Under the Longshore and Harbor Workers' Compensation Act and its Extensions 2007-05-22
1215-0202 Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act 2007-05-22
1215-0054 Medical Travel Refund Request 2007-05-22
1215-0036 Motor Vehicle Safety for Transportation of Migrant and Seasonal Agricultural Workers 2007-05-22
1215-0017 Records to be kept by Employers - FLSA 2007-05-22
1215-0178 Claim for Reimbursement-Assisted Reemployment 2007-03-28
1215-0001 Employment Information Form 2007-03-28
1215-0155 Claim for Compensation by Dependents Information Reports 2007-03-01
1215-0061 Certification By School Official 2007-03-01
1215-0059 Notice of Issuance of Insurance Policy 2007-01-19
1215-0201 The Secretary of Labor's Opportunity Award, Exemplary Voluntary Effort (EVE), and Exemplary Public Interest Contribution (EPIC) Awards 2006-10-16
1215-0028 Economic Survey Schedule 2006-04-26
1215-0080 Application for Authority for an Institution of Higher Education to Employ Its Full-Time Students at Subminimum Wages Under Regulations 29 CFR Part 519 2005-09-13
1215-0124 Maintenance of Receipts for Benefits Paid by a Coal Mine Operator 2004-04-16
1215-0196 Equal Opportunity Survey 2003-06-24
1215-0199 Alternate Employment Information Request 2002-11-06
1215-0195 Survey of Physicians Board Certified in Internal Medicine with Facilities 2001-01-31
1215-0177 Resubmission Turnaround Document 2000-11-28
1215-0106 Request for Medical Reports 2000-01-20
1215-0122 Requirements of a Bona Fide Profit-Sharing Plan or Trust 1998-09-22
1215-0136 Annual Report of Earnings 1998-06-19
1215-0012 Application for a Certificate to Employ Learners at Subminimum 1998-03-11
1215-0191 Airline Vacancy Listing 1997-06-30
1215-0051 Carrier's or Self-Insurer's Report to Deputy Commissioner 1996-08-26
1215-0087 Survivor's Notification of Beneficiary's Death 1995-06-21
1215-0184 Service Contract Act Occupational Employment Questionnaire 1995-04-28
1215-0179 NOTICE TO BENEFICIARY (RO MONTHLY) NOTICE TO BENEFICIARY (RO MBO) NOTICE TO BENEFICIARY (TF MBO) 1995-04-12
1215-0183 PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER FEDERAL EMPLOYEE PROTECTION STATUTES -- 29 CFR PART 24 1994-12-21
1215-0038 APPLICATION FOR A FARM LABOR CONTRACTOR CERTIFICATE OF REGISTRATION 1994-11-29
1215-0008 ESTABLISHMENT INFORMATION, SPANISH TRANSLATION 1994-06-20
1215-0045 ACCIDENT DATA ON SCHOOL BUS DRIVERS ANNUAL REPORT 1992-03-16
1215-0174 PATIENT ADVOCATE PILOT QUESTIONNAIRE - PHYSICIAN INTERVIEW 1992-01-15
1215-0168 WORK-DAY REPORT 1991-12-09
1215-0169 REPORTING AND EMPLOYMENT REQUIREMENTS FOR EMPLOYERS OF CERTAIN WORKERS EMPLOYED IN SEASONAL AGRICULTURAL SERVICES, 29 CFR PART 502 1991-06-21
1215-0162 GENERAL REGULATIONS UNDER THE WALSH-HEALEY PUBLIC CONTRACTS ACT, 41 CFR PART 50-201.101(A)(2)(I) AND (II), 50-201.501, 50-201.604(A) AND (C) 1991-05-02
1215-0145 WORKER INFORMATION 1991-02-25
1215-0157 GENERAL REGULATIONS UNDER THE WALSH-HEALEY PUBLIC CONTRACTS ACT 41 CFR PART 50-201.101(A)(2)(XI) 1990-03-29
1215-0172 29 CFR 517 - TRAINING WAGE PROVISIONS OF THE FAIR LABOR STANDARDS AMENDMENTS OF 1989 1990-02-28
1215-0050 MAIL HAUL CONTRACT WAGE RATE SURVEY 1989-06-27
1215-0133 MEDICAL RECORDKEEPING REQUIREMENT 1987-02-24
1215-0165 PERMISSIBLE HOURS OF EMPLOYMENT FOR BAT BOYS AND BAT GIRLS 1986-12-01
1215-0159 NOTICE OF INTENT TO EMPLOY HOMEWORKERS IN A RESTRICTED INDUSTRY 1986-08-29
1215-0016 EMPLOYEE PERSONAL INTERVIEW STATEMENT 1986-05-12
1215-0011 EMPLOYEE MAIL INTERVIEW FORM 1986-05-12
1215-0142 UNIFORM BILLING CLAIM FORM 1985-01-31
1215-0091 DECLARATION OF CITIZENSHIP 1985-01-23
1215-0114 PHYSICIAN INFORMATION FORM 1984-07-23
1215-0076 APPLICATION FOR LUMP SUM AWARD 1984-07-16
1215-0152 SURVEY OF OCCUPATIONAL WAGES AND EMPLOYEE BENEFITS IN THE CONSTRUCTION INDUSTRY, COBB COUNTY, GEORGIA 1984-03-09
1215-0089 CLAIMANT'S STATEMENT 1984-02-06
1215-0063 NOTICE OF EMPLOYEE'S INJURY OR DEATH 1983-11-21
1215-0065 REPORT OF SECTION 10(H)(1) ADJUSTMENT PAYMENTS IN SUPPORT OF CLAIM FOR REIMBURSEMENT 1983-10-11
1215-0115 REPRESENTATIVE FEE REQUEST 1983-09-28
1215-0006 WAGE TRANSCRIPTION AND COMPUTATION SHEET 1983-09-19
1215-0068 REPORT OF PAYMENTS 1983-08-30
1215-0033 REPORT OF INJURY EXPERIENCE OF SELF-INSURED EMPLOYER 1983-08-09
1215-0117 20 CFR 702.111 MAINTENANCE OF RECORDS OF INJURY/ OCCUPATIONAL DISEASE 1983-07-11
1215-0018 APPLICATION FOR SELF-INSURANCE AND FINANCIAL STATEMENT 1983-06-21
1215-0009 VERIFICATION OF DATE OF BIRTH (ENGLISH) 1983-03-03
1215-0143 SURVEY OF BLACK LUNG BENEFICIARIES 1982-11-23
1215-0141 SURVEY OF EXPENDITURES FOR EMPLOYEE COMPENSATION 1982-08-24
1215-0062 APPLICATION FOR SELF-INSURANCE 1982-06-30
1215-0139 WAGE SURVEY OF TIPPED EMPLOYEES IN HOTELS AND RESTAURANTS 1982-06-09
1215-0110 A STUDY OF ACCOMMODATIONS PROVIDED TO HANDICAPPED EMPLOYEES BY FEDERAL CONTRACTORS 1981-12-29
1215-0128 FARM LABOR CONTRACTOR REGISTRATION - 29 CFR 40.51, 40.52 AND 40.53 1981-12-01
1215-0126 CONFORMANCE RECORD SERVICE CONTRACT ACT 1981-12-01
1215-0118 20 CFR 702.148 MAITENANCE OF RECORDS OF COMPENSATION PAYMENTS 1981-10-28
1215-0030 PAYROLL 1981-07-29
1215-0101 NOTICE TO CARRIER OR SELF-INSURER EMPLOYER 1980-12-08
1215-0007 RECEIPT FOR PAYMENT OF BACK WAGES (ENGLISH & SPANISH) 1980-09-18
1215-0086 CONSTRUCTION LABOR DEMAND SYSTEM 1980-09-15
1215-0097 SERVICE CONTRACT ACT SURVEY QUESTIONNAIRE 1980-09-04
1215-0096 POLICIES AND PRACTICES OF INSURANCE CARRIERS AFFECTING APPLICANTS FOR GROUP INSURANCE 1980-03-13
1215-0053 SPOUSE'S CERTIFICATION OF MARRIAGE 1978-08-17
1215-0048 APPLICATION FOR A CERTIFICATE TO EMPLOY LEARNERS AT A WAGE L ESS THAN THE APPLICABLE WAGE ORDER MINIMUM UNDER THE FLSA 1976-11-09