Information Collection

Application for Prevailing Wage Determination

IC 235476 under ICR 201909-1205-005 · OMB 1205-0534.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0534 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 9141C Application for Prevailing Wage Determination	Form
Form ETA 9141C General Instructions (Clean).docx	Instruction
ETA 9141C Application for Prevailing Wage Determination FORM ETA-9141C.doc	Form

IC Title:

Application for Prevailing Wage Determination

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA 9141C	Application for Prevailing Wage Determination	FORM ETA-9141C.doc		Yes	Yes	Fillable Fileable
Instruction			Form ETA 9141C General Instructions (Clean).docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,314

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: 90 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	16,606	16,606
Annual IC Time Burden (Hours)	7,805	7,805
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.