Form 4750 Maintenance Wage Rate Survey Recommendation

Maintenance Wage Rate Recommendation	U.S. Department of Housing and Urban Development Office of Davis-Bacon and Labor Standards			HUD FORM 4750 OMB Approval Number 2501-0011 (Exp. 08/31/2022)
Agency:      		Agency Contact: (Person most familiar with the recommendation and its bases.)
		Name:	     
		Title:	     
		Telephone:	     
		Email:	     
The following wage rates are recommended for maintenance laborers and mechanics engaged in the operation of the low-income or affordable housing developments of the above agency. I certify that this recommendation reflects the wage rates that prevail for maintenance work performed within the operating jurisdiction of this agency. Accordingly, I request that HUD issue the following wage rates for maintenance work performed beginning on:       (insert agency fiscal year beginning date mm/dd/yyyy).
Executive Director/Designee (Type or print) Name:      		Signature
Title:      		Date:      
Work Classification(s) / Job Title(s)		Hourly Wage Rates
		Basic Wage			Fringe Benefits
     		$     			$     
     		$     			$     
     		$     			$     
     		$     			$     
     		$     			$     
     		$     			$     
     		$     			$     
     		$     			$     

(Use additional sheets, if necessary.)

Public reporting burden for this collection of information is estimated to average 2.0 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. HUD may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.

This information is being collected to record the recommended prevailing wage rates for maintenance laborers and mechanics as performed within the operating jurisdiction of the agency. This information collection facilitates the determination of prevailing maintenance wage rates pursuant to the U.S. Housing Act of 1937 and the Native American Housing Assistance and Self-Determination Act of 1996 and will assist the U.S. Department of Housing and Urban Development (HUD) to establish prevailing wage rates for maintenance workers employed in the HUD-assisted Public and Indian Housing developments. Participation in this collection is voluntary and no assurances of confidentiality are provided.

Previous editions are obsolete. Form HUD-4750 (08/2019)