Information Collection

Employment of Workers with Disabilities Under Special Certificates

IC 180251 under ICR 200907-1215-005 · OMB 1215-0005.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form WH-226 Application for Authority to Employ Workers with Disabilities at Special Minimum Wages Employment of Workers with Disabilities Under Special Certificates	Form and Instruction
WH-226 Application for Authority to Employ Workers with Disabil Form WH-226 (20090724).pdf www.dol.gov/esa/forms/whd/wh226.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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-226			http://www.dol.gov/esa/forms/whd/wh226.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	Previously Approved
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	2,250	2,250
Annual IC Cost Burden (Dollars)	1,320	1,320

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.

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