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Worker Information - Terms and Conditions of Employment
Worker Information - Terms and Conditions of Employment
OMB: 1215-0187
IC ID: 13905
OMB.report
DOL/ESA
OMB 1215-0187
ICR 200707-1215-005
IC 13905
( )
Documents and Forms
Document Name
Document Type
Form WH-516-ENGLISH
Worker Information - Terms and Conditions of Employment
Form
WH-516-ENGLISH Worker Information-Terms and Conditions of Employment
Form_WH-516_English.pdf
www.dol.gov/esa/forms/whd/Form_WH-516_English.PDF
Form
WH-516-ESPANOL Informacion Sobre el Trabajador-Terminos y Condiciones d
WH-516_Spanish.pdf
www.dol.gov/esa/forms/whd/WH-516_Spanish.PDF
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Worker Information - Terms and Conditions of Employment
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
29 CFR 500.75
29 CFR 500.76
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
WH-516-ENGLISH
Worker Information-Terms and Conditions of Employment
Form_WH-516_English.pdf
http://www.dol.gov/esa/forms/whd/Form_WH-516_English.PDF
Yes
No
Fillable Printable
Form
WH-516-ESPANOL
Informacion Sobre el Trabajador-Terminos y Condiciones de Empleo
WH-516_Spanish.pdf
http://www.dol.gov/esa/forms/whd/WH-516_Spanish.PDF
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Labor Rights Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
129,250
Number of Respondents for Small Entity:
100,000
Affected Public:
Private Sector
Private Sector:
Farms
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
3,102,000
0
0
1,507,200
0
1,594,800
Annual IC Time Burden (Hours)
77,550
0
0
8,750
0
68,800
Annual IC Cost Burden (Dollars)
93,060
0
0
50,060
0
43,000
Documents for IC
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.