Information Collection

Housing Terms and Conditions for Migrant Agricultural Workers

IC 195676 under ICR 202210-1235-003 · OMB 1235-0002.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form WH-521 Housing Terms and Conditions for Migrant Agricultural Workers	Form and Instruction
WH-521 Housing Terms and Conditions English/Spanish WH-521 Revised v2.0 (2023-06-15).docx www.dol.gov/sites/dolgov/files/WHD/legacy/files/wh521.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

200712-1215-004

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 500.75 29 CFR 500.1

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-521	Housing Terms and Conditions English/Spanish	WH-521 Revised v2.0 (2023-06-15).docx	https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/wh521.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: 1,300

Number of Respondents for Small Entity: 1,274

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	Previously Approved
Annual Number of Responses for this IC	1,300	1,300
Annual IC Time Burden (Hours)	650	650
Annual IC Cost Burden (Dollars)	52	52

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.