H-2A Program

H-2A Temporary Employment Certification Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0466 can be found here:

Documents and Forms

Document Name Document Type
Form ETA-9142A H-2A Program Form
ETA-9142A Instructions Clean.pdf Instruction
ETA-9142A H-2A Application for Temporary Employment Certification Screenshots for 9142.pdf Form
ETA-9142A H-2A Application for Temporary Employment Certification ETA-9142A Clean.pdf Form
Appendix A Appendix A Appendix A -Clean.pdf Form
ETA-9142A track changes.pdf ETA-9142A track changes version IC Document
Appendix A -Track changes.pdf ETA-9142A Appendix A track changes version IC Document
ETA-9142A Instructions track changes.pdf ETA-9142A Instructions track changes version IC Document

Information Collection (IC) Details

IC Title:	H-2A Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 655

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA-9142A	H-2A Application for Temporary Employment Certification	Screenshots for 9142.pdf	Yes	Yes	Fillable Fileable
Form	ETA-9142A	H-2A Application for Temporary Employment Certification	ETA-9142A Clean.pdf	Yes	Yes	Fillable Fileable
Form	Appendix A	Appendix A	Appendix A -Clean.pdf	Yes	Yes	Fillable Fileable
Instruction			ETA-9142A Instructions Clean.pdf	Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title: DOL/ETA-15	FR Citation: 75 FR 6884

Number of Respondents: 4,870	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	160,773	12,556	148,217
Annual IC Time Burden (Hours)	49,194	5,020	44,174
Annual IC Cost Burden (Dollars)	1,608,700	79,330	1,529,370

Documents for IC

Title	Document	Date Uploaded
ETA-9142A track changes version	ETA-9142A track changes.pdf	03/07/2016
ETA-9142A Appendix A track changes version	Appendix A -Track changes.pdf	03/07/2016
ETA-9142A Instructions track changes version	ETA-9142A Instructions track changes.pdf	03/07/2016

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