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

Applications to Employ Special Industrial Homeworkers and Workers with Disabilities

Documents and Forms

Document Name Document Type
Form WH-226A 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 Form WH-226A (20090724).pdf www.dol.gov/esa/forms/whd/wh226a.pdf Form and Instruction

Information Collection (IC) Details

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: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 525

Information Collection 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	Form WH-226A (20090724).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 %

	Approved	Previously Approved
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

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.