Information Collection

Migrant and Seasonal Agricultural Worker Protection Wage Statement

IC 195675 under ICR 202210-1235-003 · OMB 1235-0002.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form WH-501 English Migrant and Seasonal Agricultural Worker Protection Wage Statement	Form
Form WH-501 English MSPA Wage Statement Migrant and Seasonal Agricultural Worker Protection Wage Statement	Form
Form WH-501S Espanol Departmento De Trabajas De Los EE UU Migrant and Seasonal Agricultural Worker Protection Wage Statement	Form
WH-501 English MSPA Wage Statement Form_WH-501 1-28-14.pdf www.dol.gov/whd/forms/Form_WH-501.pdf	Form
WH-501 English MSPA Wage Statement Form_WH-501 1-28-14.pdf www.dol.gov/whd/forms/Form_WH-501.pdf	Form
WH-501S Espanol Departmento De Trabajas De Los EE UU Form_WH-501S 1-28-14.pdf www.dol.gov/whd/forms/Form_WH-501S.pdf	Form
WH-501S Espanol Departmento De Trabajas De Los EE UU Form_WH-501S 1-28-14.pdf www.dol.gov/whd/forms/Form_WH-501S.pdf	Form

IC Title:

Agency IC Tracking Number:

200811-1215-008

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 500.80

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	WH-501 English			http://www.dol.gov/whd/forms/Form_WH-501.pdf	Yes	No	Fillable Printable
Form	WH-501S Espanol			http://www.dol.gov/whd/forms/Form_WH-501S.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: 90,000

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Farms

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	70,980,087	1,917,502	69,062,585
Annual IC Time Burden (Hours)	1,183,001	31,958	1,151,043
Annual IC Cost Burden (Dollars)	2,839,203	76,700	2,762,503

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.

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