Records to be kept by Employers--Fair Labor Standards Act

Forms and Documents

Document Name	Status
Form WH-14 Application for Federal Certificate of Age Form and Instruction	Unchanged
Form WH-5 Written Agreements to Claim the Agricultural Student Learner Exemption to Youth Employment Resrtictions Form and Instruction	Unchanged
March 14, 2016 FR Notice PRA 1235-0018.pdf Supplementary Document	2016-07-25
SS1235-0018 20160930.doc Supporting Statement A	2016-09-30

IC Document Collections

IC ID	Document Title	Status
207305	Minimum Age Standards - Parental Consent	Unchanged
192422	Application for Authorized Basic Rate	Unchanged
192421	Records When Claiming Partial Overtime Exemption for Remedial Education	Unchanged
192420	Requirements of a Bona Fide Thrift or Savings Plan and a Bona Fide Profit-Sharing Plan or Trust	Unchanged
192419	Recording Schools With WECEP Students	Unchanged
192418	WECEP Written Training Agreement	Unchanged
192417	Work Experience and Career Exploration Program (WECEP) Application	Unchanged
192416	Waiver of Child Labor Provisions for Agricultural Employment of 10 and 11 Year Old Minors in Hand Harvesting of Short Season Crops	Unchanged
192415	Application for Federal Certificate of Age Form and Instruction	Unchanged
192414	General FLSA Records (Public Sector)	Unchanged
178590	Written Agreements to Claim the Agricultural Student Learner Exemption to Youth Employment Resrtictions Form and Instruction	Unchanged
178589	Written Agrrements to Claim the Non-Agricultural Student Learner Exemption to Youth Employment Resrtictions	Unchanged
178588	Records on State/Local Government Employees Receiving Compensatory Time	Unchanged
178587	Records on Workers with Disabilities and Patient Workers Paid Sub-Minimum Wages	Unchanged
178586	Records on Messengers and Student Learners Paid Sub-Minimum Wages	Unchanged
178585	Records on Full-Time Students Paid Sub-Minimum Wages	Unchanged
178584	Records on Certain Agricultural Employees (Employees)	Unchanged
178520	Records on Certain Agricultural Employees (Employers)	Unchanged
178518	Records on Tipped Employees	Unchanged
178515	Records When Paying Overtime on an "Applicable " or "Authorized Basic" Rate	Unchanged
178513	Records for Overtime Payments Based on Trip Rate Plans	Unchanged
178510	Petitions for Review and Reconsideration	Unchanged
13628	General FLSA Records (Private Sector)	Unchanged

ICR Details

OMB Control No: 1235-0018	ICR Reference No: 201607-1235-002
Status: Historical Active	Previous ICR Reference No: 201605-1235-002
Agency/Subagency: DOL/WHD	Agency Tracking No:
Title: Records to be kept by Employers--Fair Labor Standards 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: 12/19/2016
	Date Received in OIRA: 09/30/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019	36 Months From Approved	12/31/2016
Responses	46,057,855	0	46,057,855
Time Burden (Hours)	3,489,585	0	3,489,585
Cost Burden (Dollars)	0	0	0

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Abstract: Employers respond to these information collections to document compliance with the Fair Labor Standards Act (FLSA), 29 U.S.C. 201, et seq.

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Authorizing Statute(s): US Code: 29 USC 207(e)(8) Name of Law: Fair Labor Standards Act
   US Code: 29 USC 207(q) Name of Law: Fair Labor Standards Act
   US Code: 29 USC 211(c) Name of Law: Fair Labor Standards Act
   US Code: 29 USC 213(c) Name of Law: Fair Labor Standards Act
   US Code: 29 USC 203(l) Name of Law: Fair Labor Standards Act
   EO: EO 13658 Name/Subject of EO: Establishing a Minimum Wage for Contractors
   EO: EO 13706 Name/Subject of EO: Establishing Paid Sick Leave for Federal Contractors
   US Code: 29 USC 207(e)(3) Name of Law: Fair Labor Standards Act
  

Citations for New Statutory Requirements: EO: EO 13706 Name/Subject of EO: Establishing Paid Sick Leave for Federal Contractors

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1235-AA13	Final or interim final rulemaking	81 FR 67598	09/30/2016

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 13422	03/14/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 9592	02/25/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 23

IC Title	Form No.	Form Name
Application for Authorized Basic Rate
General FLSA Records (Public Sector)
Records on Certain Agricultural Employees (Employees)
Records on Full-Time Students Paid Sub-Minimum Wages
Records on Messengers and Student Learners Paid Sub-Minimum Wages
Records on Workers with Disabilities and Patient Workers Paid Sub-Minimum Wages
Records on State/Local Government Employees Receiving Compensatory Time
Written Agrrements to Claim the Non-Agricultural Student Learner Exemption to Youth Employment Resrtictions
Written Agreements to Claim the Agricultural Student Learner Exemption to Youth Employment Resrtictions	WH-5	Certificate of Training
Records When Paying Overtime on an "Applicable " or "Authorized Basic" Rate
Petitions for Review and Reconsideration
Records for Overtime Payments Based on Trip Rate Plans
Records on Tipped Employees
Records on Certain Agricultural Employees (Employers)
General FLSA Records (Private Sector)
Application for Federal Certificate of Age	WH-14	Application for Federal Certificate of Age
Waiver of Child Labor Provisions for Agricultural Employment of 10 and 11 Year Old Minors in Hand Harvesting of Short Season Crops
Work Experience and Career Exploration Program (WECEP) Application
WECEP Written Training Agreement
Recording Schools With WECEP Students
Requirements of a Bona Fide Thrift or Savings Plan and a Bona Fide Profit-Sharing Plan or Trust
Records When Claiming Partial Overtime Exemption for Remedial Education
Minimum Age Standards - Parental Consent

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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	46,057,855	46,057,855	0	0	0	0
Annual Time Burden (Hours)	3,489,585	3,489,585	0	0	0	0
Annual Cost Burden (Dollars)	0	0	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:

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Annual Cost to Federal Government: $0

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: 09/30/2016

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