Information Collection

H-2B Program

IC 204361 under ICR 201505-1205-001 · OMB 1205-0509.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0509 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA-9142B H-2B Application for Temporary Employment Certification H-2B Program	Form
Form ETA-9142B Appendix Appendix B H-2B Program	Form
Form ETA-9142B H-2B Application for Temporary Employment Certification H-2B Program	Form
Form ETA-9142B Appendix H-2B Application for Temporary Employment Certification H-2B Program	Form
ETA Form 9142B Instructions.doc	Instruction
2015 ETA Form 9142B Instructions Updates clean.doc	Instruction
ETA-9142B H-2B Application for Temporary Employment Certification Screenshots for 9142.pdf	Form
ETA-9142B Appendix Appendix B ETA Form 9142B Appendix B Final.doc	Form
ETA-9142B H-2B Application for Temporary Employment Certification ETA Form 9142B.doc	Form
ETA-9142B Appendix H-2B Application for Temporary Employment Certification 1205-0509-ETA Form 9142B Appendix B nonsubstantive change - Clean_5-15-2015.doc	Form
ETA Form 9142B Appendix B nonsubstantive change track changes_5-15-2015.doc ETA Form 9142B - Track-Changes	IC Document
2015 ETA Form 9142B Instructions Updates track-changes.doc Form ETA-9142B Instructions with track changes	IC Document

IC Title:

H-2B Program

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 8 CFR 214.2(h)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA-9142B	Yes	Yes	Fillable Fileable
Form	ETA-9142B Appendix B	Yes	No	Printable Only
Form	ETA-9142B	Yes	Yes	Fillable Fileable
Instruction		Yes	No	Printable Only
Form	ETA-9142B Appendix B	Yes	Yes	Fillable Fileable
Instruction		Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,505

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions, Farms

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	174,926	174,926
Annual IC Time Burden (Hours)	41,231	41,231
Annual IC Cost Burden (Dollars)	351,800	351,800

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
ETA Form 9142B - Track-Changes		05/18/2015
Form ETA-9142B Instructions with track changes		05/29/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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