Form SF 1444 SF 1444 Request for Authorization of Additional Classification a

REQUEST FOR AUTHORIZATION OF
ADDITIONAL CLASSIFICATION AND RATE

D

CHECK APPROPRIATE BOX
SERVICE CONTRACT
CONSTRUCTION CONTRACT

OMB Control Number: 9000-0066
Expiration Date: XX/XX/20XX

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork
Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number.
The OMB control number for this collection is 9000-0066. We estimate that it will take 0.083 hours to read the instructions, gather the facts, and answer the
questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of
information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.
INSTRUCTIONS: THE CONTRACTOR SHALL COMPLETE ITEMS 3 THROUGH 16, KEEP A PENDING COPY, AND SUBMIT THE REQUEST, IN
QUADRUPLICATE, TO THE CONTRACTING OFFICER.
1. TO:

2. FROM: (REPORTING OFFICE)

ADMINISTRATOR,
WAGE AND HOUR DIVISION
U.S. DEPARTMENT OF LABOR
WASHINGTON, DC 20210

R

3. CONTRACTOR
5. CONTRACT NUMBER

4. DATE OF REQUEST

7. DATE OF AWARD

6. DATE BID OPENED (SEALED
BIDDING)

8. DATE CONTRACT WORK
STARTED

9. DATE OPTION EXERCISED (If
APPLICABLE) (SERVICE
CONTRACT ONLY)

10. SUBCONTRACTOR (IF ANY)
11. PROJECT AND DESCRIPTION OF WORK (ATTACH ADDITIONAL SHEET IF NEEDED)

12. LOCATION (CITY, COUNTY, AND STATE)
13. IN ORDER TO COMPLETE THE WORK PROVIDED FOR UNDER THE ABOVE CONTRACT, IT IS NECESSARY TO ESTABLISH THE FOLLOWING RATE(S) FOR THE
INDICATED CLASSIFICATION(S) NOT INCLUDED IN THE DEPARTMENT OF LABOR DETERMINATION
NUMBER:

A

DATED:

a. LIST IN ORDER: PROPOSED CLASSIFICATION TITLE(S); JOB DESCRIPTION(S); DUTIES;
AND RATIONALE FOR PROPOSED CLASSIFICATIONS (Service contracts only)
(Use reverse or attach additional sheets, if necessary)

14. SIGNATURE AND TITLE OF SUBCONTRACTOR REPRESENTATIVE
(IF ANY)

16. SIGNATURE OF EMPLOYEE OR REPRESENTATIVE

c. FRINGE BENEFITS
PAYMENTS

b. WAGE RATE(S)

F

15. SIGNATURE AND TITLE OF PRIME CONTRACTOR REPRESENTATIVE

TITLE

CHECK APPROPRIATE BOX-REFERENCING BLOCK 13.

AGREE

DISAGREE

TO BE COMPLETED BY CONTRACTING OFFICER (CHECK AS APPROPRIATE - SEE FAR 22.1019 (SERVICE CONTRACT LABOR
STANDARDS) OR FAR 22.406-3 (CONSTRUCTION WAGE RATE REQUIREMENTS))
THE INTERESTED PARTIES AGREE AND THE CONTRACTING OFFICER RECOMMENDS APPROVAL BY THE WAGE AND HOUR DIVISION. AVAILABLE
INFORMATION AND RECOMMENDATIONS ARE ATTACHED.

THE INTERESTED PARTIES CANNOT AGREE ON THE PROPOSED CLASSIFICATION AND WAGE RATE. A DETERMINATION OF THE QUESTION BY THE WAGE
AND HOUR DIVISION IS THEREFORE REQUESTED. AVAILABLE INFORMATION AND RECOMMENDATIONS ARE ATTACHED.
(Send 3 copies to the Department of Labor)

SIGNATURE OF CONTRACTING OFFICER OR REPRESENTATIVE

AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION IS USABLE

TITLE AND COMMERCIAL TELEPHONE NUMBER

T

DATE SUBMITTED

STANDARD FORM 1444 (REV. XX/20XX)
Prescribed by GSA-FAR (48 CFR) 53.222(f)