Information Collection

Written Agreements to Claim Agricultural Student Learner Exemption to Youth Employment Restrictions

IC 237444 under ICR 202007-1235-002 · OMB 1235-0030.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form WH-5 Written Agreements to Claim Agricultural Student Learner Exemption to Youth Employment Restrictions	Form and Instruction
WH-5 Certificate of Training WH-5.pdf www.dol.gov/whd/forms/WH-5.pdf	Form and Instruction
WH-5 Certificate of Training WH-5.pdf www.dol.gov/whd/forms/WH-5.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 570.72

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-5	Certificate of Training	WH-5.pdf	https://www.dol.gov/whd/forms/WH-5.pdf	Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,150

Number of Respondents for Small Entity: 9,000

Affected Public: Private Sector

Private Sector: Farms

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20,200	20,200
Annual IC Time Burden (Hours)	337	337
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.