Information Collection

Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilities at Special Minimum Wages

IC 180252 under ICR 200705-1215-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form WH-226A Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilities at Special Minimum Wages Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilities at Special Minimum Wages	Form and Instruction
WH-226A Supplemental Data Sheet for Application for Authority to wh226a.pdf www.dol.gov/esa/forms/whd/wh226a.pdf	Form and Instruction

IC Title:

Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilities at Special Minimum Wages

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 525

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	WH-226A	Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilities at Special Minimum Wages	wh226a.pdf	http://www.dol.gov/esa/forms/whd/wh226a.pdf	Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	9,000	9,000
Annual IC Time Burden (Hours)	6,750	6,750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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