Information Collection

Prevailing Wage Determination

IC 204363 under ICR 201905-1205-005 · OMB 1205-0508.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 â Appendix A	Application for Prevailing Wage Determination Form ETA-9141 â 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 %

table that charts list of burden
	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

table that charts IC Documents
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.