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Paid
Employment Information Form
OMB: 1235-0021
IC ID: 236191
OMB.report
DOL/WHD
OMB 1235-0021
ICR 202003-1235-001
IC 236191
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1235-0021 can be found here:
2024-11-01 - Revision of a currently approved collection
2024-04-26 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
PAID compliance assist screen shot.pdf
Instruction
PAID compliance assist screen shot.pdf
Instruction
PAID screenshots.pdf
Instruction
WH-1527 PAID certificate
PAID cert screen shot.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
PAID
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
29 CFR 500.1(a)
29 CFR 801.7(a)
29 CFR 13.41-.43
20 CFR 655.1200
29 CFR 10.41-.43
29 CFR 5.6
29 CFR 501.5
29 CFR 4.191
29 CFR 825.401
41 CFR 105.50-.1202
29 CFR 501.1(c)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
PAID compliance assist screen shot.pdf
Yes
No
Printable Only
Form
WH-1527
PAID certificate
PAID cert screen shot.pdf
Yes
No
Fillable Printable
Instruction
PAID compliance assist screen shot.pdf
Yes
No
Printable Only
Instruction
PAID screenshots.pdf
Yes
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Labor Rights Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
50
Number of Respondents for Small Entity:
5
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits, Farms
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
50
0
0
0
0
50
Annual IC Time Burden (Hours)
79
0
0
0
0
79
Annual IC Cost Burden (Dollars)
2
0
0
0
0
2
Documents for IC
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.