Information Collection

Worker Information - Terms and Conditions of Employment

IC 13905 under ICR 202210-1235-003 · OMB 1235-0002.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form WH-516 Worker Information - Terms and Conditions of Employment	Form and Instruction
WH-516 Worker Information- Terms and Conditions of Employment WH-516 Revised v2.0 (2022-12-08).docx www.dol.gov/sites/dolgov/files/WHD/legacy/files/wh516.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 500.76 29 CFR 500.75

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-516	Worker Information- Terms and Conditions of Employment	WH-516 Revised v2.0 (2022-12-08).docx	https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/wh516.pdf	Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 94,729

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Farms

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,625,002	-650,001	2,275,003
Annual IC Time Burden (Hours)	45,229	-5,306	50,535
Annual IC Cost Burden (Dollars)	65,000	-26,000	91,000

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.