Migrant and Seasonal Agricultural Worker Protection Wage Statement

Disclosures to Workers Under the Migrant and Seasonal Agricultural Worker Protection Act

Documents and Forms

Document Name Document Type
Form WH-501 English 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-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

Information Collection (IC) Details

IC Title:	Migrant and Seasonal Agricultural Worker Protection Wage Statement	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	WH-501 English	MSPA Wage Statement	Form_WH-501 1-28-14.pdf	http://www.dol.gov/whd/forms/Form_WH-501.pdf	Yes	No	Fillable Printable
Form	WH-501S Espanol	Departmento De Trabajas De Los EE UU	Form_WH-501S 1-28-14.pdf	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 %

	Requested	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

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.