Disclosures to Workers Under the Migrant and Seasonal Agricultural Worker Protection Act

Forms and Documents

Document Name	Status
Form WH-521 English and Housing Terms and Conditions for Migrant Agricultural Workers Form	Modified
Form WH-501 English Migrant and Seasonal Agricultural Worker Protection Wage Statement Form	Modified
Form WH-516 English Worker Information - Terms and Conditions of Employment Form	Modified
WH-516_Spanish chgs.pdf Supplementary Document	2014-04-02
WH-516_HaitianCreole chgs.pdf Supplementary Document	2014-04-02
WH-516 chgs.pdf Supplementary Document	2014-04-02
wh521 chgs.pdf Supplementary Document	2014-04-02
1235-0002ss(201400506).doc Supporting Statement A	2014-05-06
1235-0002 FR60day 1-28-14.pdf Supplementary Document	2014-04-02

IC Document Collections

IC ID	Document Title	Status
195676	Housing Terms and Conditions for Migrant Agricultural Workers Form	Modified
195675	Migrant and Seasonal Agricultural Worker Protection Wage Statement Form	Modified
13905	Worker Information - Terms and Conditions of Employment Form	Modified

ICR Details

OMB Control No: 1235-0002	ICR Reference No: 201312-1235-001
Status: Historical Active	Previous ICR Reference No: 201210-1235-001
Agency/Subagency: DOL/WHD	Agency Tracking No:
Title: Disclosures to Workers Under the Migrant and Seasonal Agricultural Worker Protection Act
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/12/2014
	Date Received in OIRA: 05/12/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2017	36 Months From Approved	06/30/2014
Responses	84,206,505	0	84,206,505
Time Burden (Hours)	1,417,594	0	1,417,436
Cost Burden (Dollars)	3,368,260	0	3,368,260

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Abstract: Agricultural employers and associations and farm labor contractors use this information collection to disclose employment terms and conditions, wage statements, and housing terms and conditions to migrant/seasonal agricultural workers, to comply with the Migrant Seasonal Agricultural Worker Protection Act.

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Authorizing Statute(s): US Code: 29 USC 1801, et seq. Name of Law: Migrant and Seasonal Agricultural Worker Protection Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 4508	01/28/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 26997	05/12/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Worker Information - Terms and Conditions of Employment	WH-516 English, WH-516 Spanish, WH-516 Haitian Creole	Worker Information-Terms and Conditions of Employment ,   Informacion Sobre el Obrero-Terminos y Condiciones de Empleo ,   Lwa sou Pwoteksyon Travaye Agrikol Migran epi Tanpore
Housing Terms and Conditions for Migrant Agricultural Workers	WH-521 English and Spanish	Housing Terms and Conditions for MSPA Workers
Migrant and Seasonal Agricultural Worker Protection Wage Statement	WH-501 English, WH-501S Espanol	MSPA Wage Statement ,   Departmento De Trabajas De Los EE UU

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	84,206,505	84,206,505	0	0	0	0
Annual Time Burden (Hours)	1,417,594	1,417,436	0	0	158	0
Annual Cost Burden (Dollars)	3,368,260	3,368,260	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The 158 burden hour increase is due to the correction of an inadvertent error in the average response time for each disclosure of terms and conditions of employment used during the prior ICR's clearance.

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Annual Cost to Federal Government: $62,256

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/12/2014

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