Information Collection

Application For Special Certificates Under The Flsa Requirements

IC 121779 under ICR 198508-1215-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

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Information Collection (IC) Details

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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:

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: 25,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	25,200	1,500	23,700
Annual IC Time Burden (Hours)	22,673	9,340	13,333
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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