Form WH-75 Homeworker Handbook

Application to Employ Homeworkers; Piece Rate Measurements; and Homeworker Handbooks

WH-75 english.Final Draft Version (8-28-09)

Homeworker Handbook

OMB: 1235-0019

Document [pdf]
Download: pdf | pdf
Homeworker Handbook

U.S. Department of Labor
Employment Standards Administration
Wage and Hour Division

O.M.B. No. 1215-0013
Expires: xx/xx/xxxx

This handbook is the property of the Wage and Hour Division, Employment Standards Administration, United
States Department of Labor, and must be returned upon request. This is a Federal handbook only and does not
authorize the distribution of homework by any employer or by any contractor in violation of any applicable State
law or regulation.
1. A. Homeworker's name: (last name) (first name)

B. Address: (number, street, city, State, Zip code)

2. A. Firm's name:

B. Address: (number, street, city, State, ZIP code)

3. Homework distributed from: (number, street, city, State, Zip code)

4. Industry:

5. Day and time workweek begins

6. Required minimum wage

7. Date issued to homeworker (month, day, year):

8. Homeworker's certificate number (if applicable) (See Regulations 29 C.F.R. § 530.4)

Form WH-75
(Revised June 2009)

NOTICE TO EMPLOYER AND HOMEWORKER
1. Under the Fair Labor Standards Act, homeworkers are entitled to the same protections of the law as other
employees. Any violations committed with respect to homeworkers are subject to the penalties set forth in
the law and in Regulations, 29 C.F.R. Parts 530 and 579.
2. Homeworkers must be paid at a rate of not less than the minimum wage provided in the Act for all hours
worked unless a lower rate is permitted under a special certificate for an individual homeworker in
accordance with Regulations, 29 C.F.R. Part 525.
3. Homeworkers must be paid overtime pay at a rate of not less than one and one-half times their regular
rates of pay for all hours of work after 40 in a workweek.
4. Deductions from wages for damaged goods, cost of tools or materials (yarn, thread, packing materials,
etc.), cost of machines or other equipment, etc., are not permitted and workers may not themselves pay
such costs without reimbursement where this reduces the wages received to less than the minimum wage
or cuts into required overtime pay.
5. No one under 16 years of age is permitted to perform industrial homework as defined in Regulations, 29
C.F.R. Part 530.
6. The work record entered in this handbook must be only for the employee named on the front page.
7. Records of hours worked and earnings of homeworkers must be kept by the employer in accordance
with section 516.31 of Regulations, 29 C.F.R. Part 516.
8. No homework may be performed on Government manufacturing or supply contracts subject to the
Walsh-Healey Public Contracts Act.

Public Burden Statement
According to the Paperwork Reduction Act of 1995, no persons are required to response to this collection of information unless it displays a
currently valid OMB control number. This collection of information is authorized by section 11(d) of the Fair Labor Standards Act (FLSA).
29 U.S.C. § 211(d). Completion of this form is voluntary; however, the obligation to respond to this collection of information is required to obtain or
retain the benefit of employing industrial homeworkers. 29 C.F.R. § 516.31. The information must be provided in order to ensure that employers
fulfill their obligations under the FLSA with regard to industrial homeworkers. We estimate that it will take an average of 30 minutes to complete
this collection of information, including 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 this burden, to the U.S. Department of Labor, Administrator, Wage and Hour
Division, ESA, Room S3502, 200 Constitution Avenue, N.W., Washington, D.C. 20210.
DO NOT SEND THE COMPLETED FORM TO THIS OFFICE

INSTRUCTIONS
(Enter in ink all information required)
Each page of this handbook is a time sheet to be used by the homeworker to accurately record all the
hours worked in one workweek. A workweek is a fixed period of 7 consecutive calendar days - 168 hours.
The employer designates the time of the day and day of the week on which the workweek begins.
In many instances, a homeworker does not work continuously, so space has been provided for several
daily entries of starting and stopping times, if needed. It is important that the homeworker accurately
record each time he or she starts and stops working (for example, ''Start" - 8:15 a.m.; ''Stop'' - 10:45 a.m.).
This time should be recorded immediately when he or she starts and stops working, rather than at the end
of the day or workweek. However, short breaks or rest periods of less than 20 minutes need not be recorded.
Activities which must be considered hours worked (and paid for each pay period) include all time spent in:
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(i)

(j)
(k)

setting up and putting away machines and materials,

adjusting, threading, cleaning, oiling, or repairing machines,

actual production of the articles,

inspection of the articles,

repairing or re-work,

sorting and packing or unpacking materials,

training to produce new designs or new items,

rest periods of short duration (up to 20 minutes),

traveling to and from the distribution point to pick up and/or deliver the homeworker's own

work or the work of other homeworkers (where the travel includes time spent in personal
activities, such as shopping or going to the post office, this personal travel time need not
be included in counting the hours worked),
waiting at the distribution point to pick up work or deliver completed work and have it
inspected,
any other activity required to produce the article, or otherwise required by the employer to
be performed.

In the space indicated, the homeworker is to record the type(s) of article(s) worked on each day, the number
of pieces made, and any other activities (travel, packing, etc.). The homeworker also is to record all
business-related expenses incurred during the workweek, such as cost of thread and tools, postage, etc.,
in the space provided at the bottom of the time sheet.
Except for the time necessary for the calculation of hours worked at the end of the pay period by the
employer, the handbook shall remain in the possession of the homeworker until filled in (that is, no space
is left for entries) or until the homeworker's employment is terminated, at which time the handbook shall
be returned to the employer as required by the regulations. The employer then signs and dates the
statement on the final page and keeps and preserves the handbook for at least 2 years.
For further information or additional handbooks, contact the nearest office of the Wage and Hour Division,
Employment Standards Administration, United States Department of Labor.

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

Article (hat, glove, etc.)
Style or lot number and number of pieces of each
Other activities (travel, packing, etc.)

Workweek Ending Date:
Stop

Hours

Day 7

Day 6

Day 5

Day 4

Day 3

Day 2

Day 1

Start

Total
Hours

Expenses (description/amount)

I attest that the homeworker to whom this handbook was issued was instructed to accurately
record all hours worked, piece work information, and business-related expenses. I also attest
that, to the best of my knowledge and belief, the information was recorded accurately.

Date

Signature of Employer


File Typeapplication/pdf
File TitleFLSA Homeworker Handbook
SubjectWHD Publication Handbook WH75
AuthorWHD Web Team
File Modified2009-08-28
File Created2003-09-29

© 2024 OMB.report | Privacy Policy