OMB
.report
Search
Employment Information Form
Employment Information Form
OMB: 1235-0021
IC ID: 13616
OMB.report
DOL/WHD
OMB 1235-0021
ICR 201409-1235-001
IC 13616
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1235-0021 can be found here:
2024-11-01 - Revision of a currently approved collection
2024-04-26 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form WH-3-Sp
Employment Information Form
Form and Instruction
WH-3-Sp Employment Information Form Spanish
wh3Sp.pdf
Form and Instruction
WH-3 Employment Information Form
wh3.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Employment Information Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
29 CFR 500.1(e)
29 CFR 801.7(a)(3)
29 CFR 825.401
41 CFR 50-201.1202
29 CFR 501.1(c)
29 CFR 501.5
20 CFR 655.1200(b)
29 CFR 5.6
29 CFR 4.191
(To search for a specific CFR, visit the
Code of Federal Regulations.
)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
WH-3-Sp
Employment Information Form Spanish
wh3Sp.pdf
No
Paper Only
Form and Instruction
WH-3
Employment Information Form
wh3.pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Labor Rights Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
35,350
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
35,350
0
350
0
0
35,000
Annual IC Time Burden (Hours)
11,783
0
116
0
0
11,667
Annual IC Cost Burden (Dollars)
0
0
0
0
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.