Prevailing Wage Determination

Application for Prevailing Wage Determination

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0508 can be found here:

Documents and Forms

Document Name Document Type
ETA Form 9141 Instructions.pdf Instruction
New - Form ETA-9141 General Instructions.docx Instruction
ETA-9141 Application for Prevailing Wage Determination ETA Form 9141.pdf Form
Form ETA-9141 – Ap Application for Prevailing Wage Determination Form ETA-9 CLEAN - 6. Form ETA-9141 App. A.docx Form
ETA-9141 Application for Prevailing Wage Determination NEW - Form ETA-9141.docx Form
Form ETA-9141 - Ap Form ETA-9141 Appendix A, Request for Additional Worksit New - Form ETA-9141 Appendix A.docx Form
RECONCILED - TRACKED - 5. Form ETA-9141 05.30.19.docx FORM ETA-9141 - Track Changes IC Document
RECONCILED - TRACKED - 7. Form ETA-9141 General Instructions 05.30.19.docx Form ETA-9141- General Instructions - Track Changes IC Document
Form ETA-9141 Appendix A tracked 05.30.19.docx Form ETA-9141 - Appendix A - Request for Additional Worksites IC Document

Information Collection (IC) Details

IC Title:	Prevailing Wage Determination	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 655.10 8 CFR 214.2(h)(6) 20 CFR 655.731 20 CFR 650.40

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			ETA Form 9141 Instructions.pdf	Yes	No	Printable Only
Form	ETA-9141	Application for Prevailing Wage Determination	ETA Form 9141.pdf	Yes	Yes	Fillable Fileable
Form	Form ETA-9141 – Appendix A	Application for Prevailing Wage Determination Form ETA-9141 – Appendix A, Request for Additional Worksite(s)	CLEAN - 6. Form ETA-9141 App. A.docx	Yes	Yes	Fillable Fileable
Form	ETA-9141	Application for Prevailing Wage Determination	NEW - Form ETA-9141.docx	Yes	Yes	Fillable Fileable
Instruction			New - Form ETA-9141 General Instructions.docx	Yes	No	Printable Only
Form	Form ETA-9141 - Appendix A	Form ETA-9141 Appendix A, Request for Additional Worksite(s)	New - Form ETA-9141 Appendix A.docx	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 88,599	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: 99 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	320,850	-681,742	1,002,592
Annual IC Time Burden (Hours)	143,194	-305,187	448,381
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
FORM ETA-9141 - Track Changes	RECONCILED - TRACKED - 5. Form ETA-9141 05.30.19.docx	05/30/2019
Form ETA-9141- General Instructions - Track Changes	RECONCILED - TRACKED - 7. Form ETA-9141 General Instructions 05.30.19.docx	05/30/2019
Form ETA-9141 - Appendix A - Request for Additional Worksites	Form ETA-9141 Appendix A tracked 05.30.19.docx	05/30/2019

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