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OMB No. 3206-0036
Expires Nov 30, 2008
FEDERAL WAGE SYSTEM - ESTABLISHMENT INFORMATION
The public reporting burden for this collection of information is estimated to average 4 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (3206-0036). Respondents should be aware that notwithstanding any other provision of law, no
person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION.
1. ESTABLISHMENT NAME AND ADDRESS (Include Apartment
2. WAGE AREA
or Suite Number and 9-digit ZIP Code)
3. DATE OF CONTACT 4. TELEPHONE NUMBER (Include Area Code
(YYYYMMDD)
and Extension)
5. NAME AND TITLE OF PERSON(S) INTERVIEWED
6. PRODUCT OR SERVICE OF ESTABLISHMENT
a. MAJOR INDUSTRY
b. SPECIFIC PRODUCTS OR SERVICES
7. AREA CODE
9. STANDARD INDUSTRIAL
CLASSIFICATION (SIC) CODE
8. ESTABLISHMENT CODE
10. ESTABLISHMENT WEIGHT
11. TOTAL NUMBER
EMPLOYEES IN
ESTABLISHMENT
12. TOTAL NUMBER BLUECOLLAR EMPLOYEES
14. NUMBER OF HOURS IN
NORMAL WORKWEEK
15. MONTH GENERAL WAGE ADJUSTMENTS 16. CONTRACT OBTAINED (X one)
ARE NORMALLY EFFECTIVE
YES
99 = NO SET MONTH
NO
1 = JANUARY
ETC.
RATE SHEET
13. OVERTIME PAY PROVISIONS
DAILY
RATE
a. DATE
(YYYYMMDD)
b. AMOUNT
RATE
HOURS
SUNDAY
HOLIDAY
RATE
RATE
17. NON-PAR CODE
19. ADDITIONAL PAY ELEMENTS (Explain in Remarks)
18. GENERAL WAGE ADJUSTMENTS
c. INCREASE/
DECREASE
(Enter I or D)
WEEKLY
HOURS
d. INCLUDED IN
RATES (X one)
YES
NO
a. BONUS
b. LUMP SUM
c. INCENTIVE
20. COST OF LIVING ALLOWANCE (COLA)
a. COLA FORMULA
b. BASE PERIOD
(
) 1967=100
(
) 1982-84=100
d. PAY ON
= 1c
e. USING CONSUMER
PRICE INDEX (CPI)
FOR
c. INDEX
21. COLA TIED DIRECTLY TO CPI
YES
a. TOTAL AMOUNT
BEING PAID
NO
(
) CPI - U
(
) CPI - W
b. DATE AND AMOUNT OF ADJUSTMENTS
c. FOLD-IN
d. CARRYOVER
DATE
AMOUNT
22. REMARKS
23. PRINTED NAME AND SIGNATURE
24. PRINTED NAME AND SIGNATURE
PAGE 1 OF
DD FORM 1918, NOV 2005
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Office of Personnel Management,
Operating Manual, Federal Wage System
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File Modified | 0000-00-00 |
File Created | 0000-00-00 |