WAGE STATEMENT (ENGLISH AND SPANISH)

ICR 199404-1215-003

OMB: 1215-0148

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
122285 Migrated
ICR Details
1215-0148 199404-1215-003
Historical Active 199105-1215-004
DOL/ESA
WAGE STATEMENT (ENGLISH AND SPANISH)
Revision of a currently approved collection   No
Regular
Approved without change 07/14/1994
Retrieve Notice of Action (NOA) 04/20/1994
Approved on the condition that DOL clearly indicate on the form that this optional form need not be reported to DOL.
  Inventory as of this Action Requested Previously Approved
08/31/1997 08/31/1997 07/31/1994
1,500,000 0 52,000
325,000 0 60,666
0 0 0

THE IMMIGRATION AND NATIONALITY ACT REQUIRES EMPLOYERS OF REPLENISHMEN WORKERS TO PROVIDE A REPORT TO THE WORKER CERTIFYING THEIR EMPLOYMENT WITH EACH WAGE PAYMENT. THE MIGRANT AND SEASONAL AGRICULTURAL WORKER PROTECTION ACT REQUIRES EMPLOYERS OF AGRICULTURAL WORKERS TO MAINTAIN SPECIFIC WEEKLY PAYROLL INFORMATION AND PROVIDE WRITER COPIES TO EACH WORKER AND THE PERSON FURNISHED THE WORKER.

None
None


No

1
IC Title Form No. Form Name
WAGE STATEMENT (ENGLISH AND SPANISH) WH-501R, WH-501R(S)

  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 1,500,000 52,000 0 0 1,448,000 0
Annual Time Burden (Hours) 325,000 60,666 0 0 264,334 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.
04/20/1994


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