Information Collection

Form ETA-9142-B-CAA-3

IC 235962 under ICR 201905-1205-002 · OMB 1205-0535.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0535 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form ETA9142-B-CAA Form ETA-9142-B-CAA-3	Form
508 Form ETA 9142-B-CAA-3_General Instructions -DHS-OGC 4.17 DOL (1).pdf	Instruction
Form ETA9142-B-CAA Attestation for Employers Seeking to Employ H-2B Nonimmi 508 Form ETA 9142-B-CAA-3_G-DHS-OGC 4-17 DOL.pdf	Form

IC Title:

Form ETA-9142-B-CAA-3

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 655 8 CFR 214

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Form ETA9142-B-CAA-3	Attestation for Employers Seeking to Employ H-2B Nonimmigrant Workers Under Section 105 of Division H of the Consolidated Appropriations Act, 2019 Public Law 116-6 (February 15, 2019)	508 Form ETA 9142-B-CAA-3_G-DHS-OGC 4-17 DOL.pdf		Yes	No	Fillable Printable
Instruction			508 Form ETA 9142-B-CAA-3_General Instructions -DHS-OGC 4.17 DOL (1).pdf		Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,776

Number of Respondents for Small Entity: 3,700

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	3,776	3,776
Annual IC Time Burden (Hours)	21,712	21,712
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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