ESTABLISHMENT INFORMATION FORM (ALSO SPANISH VERSION)

ICR 197801-1215-001

OMB: 1215-0008

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
121789 Migrated
ICR Details
1215-0008 197801-1215-001
Historical Active 197604-1215-001
DOL/ESA
ESTABLISHMENT INFORMATION FORM (ALSO SPANISH VERSION)
Revision of a currently approved collection   No
Regular
Approved without change 01/23/1978
Retrieve Notice of Action (NOA) 01/17/1978
  Inventory as of this Action Requested Previously Approved
11/30/1982 11/30/1982 04/30/1981
4,500 0 4,500
750 0 750
0 0 0

FORM IS USED IN DETERMINING POSSIBLE COVERAGE AS WELL AS OTHER PERTINENT INFORMATION ABOUT THOSE ESTABLISHMENTS WHO ARE BEING CONSIDERED FOR INVESTIGATION UNDER THE FLSA. ALSO PRINTED IN SPANISH.

None
None


No

1
IC Title Form No. Form Name
ESTABLISHMENT INFORMATION FORM (ALSO SPANISH VERSION) WH-45

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,500 4,500 0 0 0 0
Annual Time Burden (Hours) 750 750 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
01/17/1978


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