Information Collection Request

Employer-Provided Survey Attestations to Accompany H-2B Prevailing Wage Determination Request Based on a Non-OES Survey

ICR 201510-1205-006 · OMB 1205-0516 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form ETA-9165 H-2B Employer-Provided Survey Attestation Form Modified Available
1205 0516 Form ETA 9165 Comment response to Baker.docx Supplementary Document Uploaded 2015-12-31 Available
Revised SSA 1205-0516 ETA-9165 Supporting Statement 12.30.2105.doc Supporting Statement A Uploaded 2015-12-30 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
215966 H-2B Employer-Provided Survey Attestation Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2018 36 Months From Approved 12/31/2015
278 0 556
116 0 348
217,523 0 211,884





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table that charts list of burden
IC Title Form No. Form Name
H-2B Employer-Provided Survey Attestation ETA-9165 Employer-Provided Survey Attestations to Accompany H-2B Prevailing Wage Determination Request Based on a Non-OES Survey

table that charts list 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 278 556 0 0 -278 0
Annual Time Burden (Hours) 116 348 0 0 -232 0
Annual Cost Burden (Dollars) 217,523 211,884 0 0 5,639 0


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