Information Collection

Wage Statement

IC 43807 under ICR 201003-1235-009 · OMB 1235-0009.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form WH-501S Ley de Proteccion de los Obreros Migratorios y Estacionales Agricolas, Diario De D?as Trabajados Wage Statement	Form and Instruction
Form WH-501 Migrant and Seasonal Agricultural Worker Protection Act Wage Statement Wage Statement	Form and Instruction
WH-501S Ley de Proteccion de los Obreros Migratorios y Estaciona WH-501S (3-24-09 Version).pdf www.dol.gov/esa/WHD/forms/Form_WH-501S.pdf	Form and Instruction
WH-501 Migrant and Seasonal Agricultural Worker Protection Act WH-501E (3-24-09 Version).pdf www.dol.gov/esa/WHD/forms/Form_WH-501.pdf	Form and Instruction

IC Title:

Wage Statement

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 500.1(i)(1) 29 CFR 500.80

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-501S			http://www.dol.gov/esa/WHD/forms/Form_WH-501S.pdf	Yes	No	Fillable Printable
Form and Instruction	WH-501			http://www.dol.gov/esa/WHD/forms/Form_WH-501.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: 51,542

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Farms

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	42,925,000	1,581,000	41,344,000
Annual IC Time Burden (Hours)	715,417	26,350	689,067
Annual IC Cost Burden (Dollars)	2,146,250	2,146,250	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.

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