Information Collection

Applications to Employ Special Industrial Homeworkers and Workers with Disabilities

IC 13619 under ICR 200102-1215-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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:	Applications to Employ Special Industrial Homeworkers and Workers with Disabilities	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	WH-226A	No	No
Form	WH-2	No	No
Form	WH-226	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,550	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	16,550	-12,017	-33	28,600
Annual IC Time Burden (Hours)	12,400	-9,000	-25	21,425
Annual IC Cost Burden (Dollars)	2,000	0	-1,000	3,000

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.