Application for Temporary Employment Certification

CW-1 Application for Temporary Employment Certification

Documents and Forms

Document Name Document Type
Form ETA-9142C Application for Temporary Employment Certification Form
Form ETA-9142C General Instructions - 1205-0534 (9-3-21).docx Instruction
ETA-9142C CW-1 Application for Temporary Employment Certification Form ETA 9142C - 1205-0534 (9-3-21).docx Form
ETA-9142C Appendix A Form ETA-9142C Appendix A - 1205-0534 (9-3-21).docx Form
ETA-9142C Appendix B Form ETA-9142C Appendix B - 1205-0534 (9-3-21).docx Form
ETA-9142C Appendix C Form ETA-9142C Appendix C - 1205-0534 (9-3-21).docx Form
ETA-9142C Final Determination ETA-9142C, Final Determination - 1205-0534 (9-3-21).docx Form
Form_ETA_9142C_CW1_TLC_CasePrepiew Screenshots.docx Form 9142C Screenshots IC Document

Information Collection (IC) Details

IC Title:	Application for Temporary Employment Certification	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:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA-9142C	CW-1 Application for Temporary Employment Certification	Form ETA 9142C - 1205-0534 (9-3-21).docx	Yes	Yes	Fillable Fileable
Form	ETA-9142C	Appendix A	Form ETA-9142C Appendix A - 1205-0534 (9-3-21).docx	Yes	Yes	Fillable Fileable
Form	ETA-9142C	Appendix B	Form ETA-9142C Appendix B - 1205-0534 (9-3-21).docx	Yes	Yes	Fillable Fileable
Form	ETA-9142C	Appendix C	Form ETA-9142C Appendix C - 1205-0534 (9-3-21).docx	Yes	Yes	Fillable Fileable
Form	ETA-9142C	Final Determination	ETA-9142C, Final Determination - 1205-0534 (9-3-21).docx	Yes	Yes	Fillable Fileable
Instruction			Form ETA-9142C General Instructions - 1205-0534 (9-3-21).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: 2,730	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Farms, Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 90 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	17,606	-16,021	33,627
Annual IC Time Burden (Hours)	9,352	-3,672	13,024
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Form 9142C Screenshots	Form_ETA_9142C_CW1_TLC_CasePrepiew Screenshots.docx	09/08/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.