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pdfOMB No. 3206-0036
OMB approval expires Apr 30, 2018
FEDERAL WAGE SYSTEM - ESTABLISHMENT INFORMATION
The public reporting burden for this collection of information is estimated to average 1.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense,
W ashington Headquarters Services, Executive Services Directorate, Information Management Division, 1155 Defense Pentagon, W ashington, DC 20301-1155 (3206-0036). Respondents should be aware that notwithstanding any other
provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION.
1. ESTABLISHMENT NAME AND ADDRESS
or Suite Number and 9-digit ZIP Code)
(Include Apartment
2. WAGE AREA
3. DATE OF CONTACT
(YYMMDD)
4. TELEPHONE NUMBER (Include Area Code
and Extension)
FAX
6. PRODUCT OR SERVICE OF ESTABLISHMENT
5. NAME AND TITLE OF PERSON(S) INTERVIEWED
a. MAJOR INDUSTRY
b. SPECIFIC PRODUCTS OR SERVICES
7. AREA CODE
8. ESTABLISHMENT CODE
9. NORTH AMERICAN INDUSTRY
10. ESTABLISHMENT WEIGHT
CLASSIFICATION SYSTEM (NAICS) CODE
11. TOTAL NUMBER
EMPLOYEES IN
ESTABLISHMENT
12. TOTAL NUMBER BLUECOLLAR EMPLOYEES
SAMPS:
13. OVERTIME PAY PROVISIONS
14. NUMBER OF HOURS IN
NORMAL WORKWEEK
15. MONTH GENERAL WAGE ADJUSTMENTS
ARE NORMALLY EFFECTIVE
99 = NO SET MONTH
1 = JANUARY
ETC.
18. GENERAL WAGE ADJUSTMENTS
a. DATE
(YYMMDD)
b. AMOUNT
DAILY
RATE
HOURS
WEEKLY
RATE
16. CONTRACT OBTAINED (X one)
SUNDAY
HOLIDAY
RATE
RATE
17. NON-PAR CODE
Y = Yes N = No R = Rate Sheet
19. ADDITIONAL PAY ELEMENTS
c. INCREASE/ d. INCLUDED
DECREASE
IN RATES
(Enter I or D) (Enter Y or N)
HOURS
a. BONUS
(Explain in Remarks)
b. LUMP SUM
c. INCENTIVE
20. COST OF LIVING ALLOWANCE (COLA)
a. COLA FORMULA
= 1 CENT
b. BASE PERIOD
(
)
1967 = 100
(
)
1982-84 = 100
d. PAY ON
e. USING CONSUMER
PRICE INDEX (CPI) FOR
c. INDEX
21. COLA TIED DIRECTLY TO CPI
Y or N
a. TOTAL AMOUNT
BEING PAID
(
)
CPI - U
(
)
CPI - W
b. DATE AND AMOUNT OF ADJUSTMENTS
c. FOLD-IN
d. CARRYOVER
DATE
AMOUNT
22. REMARKS
P.O. Box:
City:
State:
Zip Code:
Zip + 4:
Prior Est Code
Mailing Address:
23. PRINTED NAME AND SIGNATURE
24. PRINTED NAME AND SIGNATURE
PAGE 1 OF
DD FORM 1918, APR 2015 (EG)
PREVIOUS EDITION IS OBSOLETE
PAGES
Office of Personnel Management
Operating Manual, Federal Wage System
File Type | application/pdf |
File Modified | 2017-09-13 |
File Created | 2017-09-13 |