Information Collection

Applications to Employ Special Industrial Homeworkers and Workers with Disabilities

IC 13621 under ICR 200409-1215-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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-226	No	No
Form	WH-2	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	Previously Approved
Annual Number of Responses for this IC	16,550	16,550
Annual IC Time Burden (Hours)	12,400	12,400
Annual IC Cost Burden (Dollars)	2,000	2,000

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.