Dd-1919 Federal Wage System - Wage Data Collection

OMB No. 3206-0036
OMB approval expires Apr 30, 2018

FEDERAL WAGE SYSTEM - WAGE DATA COLLECTION

The public reporting burden for this collection of information is estimated to average 1.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense,
W ashington Headquarters Services, Executive Services Directorate, Information Management Division, 1155 Defense Pentagon, W ashington, DC 20301-1155 (3206-0036). Respondents should be aware that notwithstanding any other
provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION.
1. ESTABLISHMENT NAME

2. WAGE AREA

4a. ESTABLISHMENT JOB TITLE

b. UNION AFFILIATION

3. DATE OF CONTACT
(YYMMDD)

c. ESTABLISHMENT GRADE

5. SURVEY JOB TITLE

6. AREA CODE

7. ESTABLISHMENT
CODE

8. JOB NUMBER

9. FORMAL
RATE
RANGE

10. JOB RATE RANGE
MINIMUM

MAXIMUM

11. NUMBER OF
ESTABLISHED
STEP RATES

Y or N

12. ESTABLISHED
STEP RATES

13. JOB MATCH

Y = YES
N = NO

14. NUMBER OF
EMPLOYEES

15. STRAIGHT TIME
HOURLY RATE

18. COST OF LIVING
ALLOWANCE
(COLA)

19. BONUS

16. GUARANTEED
MINIMUM

20. LUMP SUM

17. INCENTIVE
RATE

21. JOB SUBNUMBER

TOTAL
22. DESCRIPTION OF ESTABLISHMENT JOB

23. DO ABOVE RATES INCLUDE
N or Y

24. REMARKS
AMOUNT

COLA
BONUS
LUMP SUM
SHIFT PA
OTHER ADD-ON
(Explain)

25. SIGNATURE

26. SIGNATURE

PAGE
OF

DD FORM 1919, APR 2015 (EG)

PREVIOUS EDITION IS OBSOLETE.

PAGES

Office of Personnel Management
Operating Manual, Federal W age System