Information Collection

Application For Special Certificates Under The Flsa Requirements

IC 121778 under ICR 198306-1215-005 · OMB 1215-0005.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1215-0005 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

APPLICATION FOR SPECIAL CERTIFICATES UNDER THE FLSA REQUIREMENTS

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	WH-2, 205,	No	No
Form	222,	No	No
Form	226,	No	No
Form	227,	No	No
Form	247,	No	No
Form	249,	No	No
Form	& 373	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 17,100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	23,700	-8,600	32,300
Annual IC Time Burden (Hours)	13,333	-3,667	17,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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