H-2A Program

H-2A Application for Temporary Employment Certification

⚠️ Notice: This information collection may be referencing outdated material.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
Form ETA-9142A General Instructions_FINAL 10.22.18.pdf Instruction
H-2A Quick Start Guide_Enhancement_Document.pdf Other-Quick Start Guide
ETA-9142A H-2A Application for Temporary Employment Certification Form ETA-9142A_FINAL 10.24.18.pdf Form
ETA-9142A - Append Appendix A ETA Form 9142A Appendix A -clean.doc Form
DRAFT ETA Form 9142A_proposed revisions_10.11.18.pdf Track Changes Form ETA-9142A IC Document
DRAFT ETA_Form_9142A_General_ Instructions_in track changes_10.22.18.pdf Track Changes Form ETA-9142A General Instructions 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: Required to Obtain or Retain Benefits

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	Form ETA-9142A_FINAL 10.24.18.pdf	Yes	Yes	Fillable Fileable
Instruction			Form ETA-9142A General Instructions_FINAL 10.22.18.pdf	Yes	No	Printable Only
Form	ETA-9142A - Appendix A	Appendix A	ETA Form 9142A Appendix A -clean.doc	Yes	Yes	Fillable Fileable
Other-Quick Start Guide			H-2A Quick Start Guide_Enhancement_Document.pdf	Yes	Yes	Fillable Fileable

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

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Previously Approved
Annual Number of Responses for this IC	160,773	160,773
Annual IC Time Burden (Hours)	49,194	49,194
Annual IC Cost Burden (Dollars)	1,608,700	1,608,700

Documents for IC

Title	Document	Date Uploaded
Track Changes Form ETA-9142A	DRAFT ETA Form 9142A_proposed revisions_10.11.18.pdf	10/25/2018
Track Changes Form ETA-9142A General Instructions	DRAFT ETA_Form_9142A_General_ Instructions_in track changes_10.22.18.pdf	10/25/2018

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