Information Collection

Housing Terms and Conditions for Migrant Agricultural Workers

IC 195676 under ICR 202001-1235-002 · OMB 1235-0002.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1235-0002 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form WH-521 English/Spa Housing Terms and Conditions for Migrant Agricultural Workers	Form and Instruction
WH-521 English/Spa Housing Terms and Conditions WH-521 20200622 ES.docx www.dol.gov/agencies/whd/forms	Form and Instruction

IC Title:

Housing Terms and Conditions for Migrant Agricultural Workers

Agency IC Tracking Number:

200712-1215-004

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 500.75 29 CFR 500.1

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 and Instruction	WH-521 English/Spanish	Housing Terms and Conditions	WH-521 20200622 ES.docx	https://www.dol.gov/agencies/whd/forms	Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,300

Number of Respondents for Small Entity: 1,274

Affected Public: Private Sector

Private Sector: Farms, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,300	1,300
Annual IC Time Burden (Hours)	650	650
Annual IC Cost Burden (Dollars)	52	52

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.