Form ETA-232 Domestic Agricultural In-Season Wage Report

OMB Approval: 1205-0466

Expiration Date: XX/XX/XXXX

Domestic Agricultural In-Season Wage Report

Form ETA-232

U.S. Department of Labor

^{This form is for} use of State Workforce Agencies to submit survey results for prevailing wage determinations. Please read and review the Form ETA-232 form instructions carefully before completing this form electronically. A copy of the instructions can be found at http://www.foreignlaborcert.doleta.gov/. Those items marked with an asterisk (*) are required and must be completed. Items marked with the section symbol (§) are conditional and are to be completed if the condition is met.

A. State Workforce Agency Prevailing Wage Survey Point of Contact

1. Name *	2. Title *	3. State *
4. Telephone number *	5. Email address *

B. Survey Information and Results

1. Is the ETA-232 a resubmission? *			Yes No
2. A copy of the wage survey is attached. *				Yes
3. Identify the State agency, college, or university that conducted the survey. *
3a. Surveyor name, if different from Item A.1. §		3b. Surveyor title. §
3c. Surveyor telephone number. §		3d. Surveyor email address. §
4. Identify the geographic area of the wage report. *
5. Identify the crop activity or agricultural activity covered by the survey. *
5a. Identify the distinct work task(s) in the crop activity or agricultural activity covered by the survey. *
6. The survey result meets each regulatory criteria to produce a prevailing wage rate (See Section C). *			Yes No
6a. Prevailing wage rate. § $ ________________________________	6b. Per (choose only one) §  Hour  Week Month  Piece Rate (unit): ______________________________________________________
7. Comments (describe variables affecting rates, crop conditions, or other explanatory and pertinent information): §

C. Survey Data and Methodology

1. The survey was independently conducted by the State (e.g., any State agency, State college, or State university). *		Yes No
2. The survey covers work performed in a single crop activity or agricultural activity and, if applicable, a distinct work task or tasks performed in that crop activity or agricultural activity. *		Yes No
3. The survey covers an appropriate geographic area based on available resources to conduct the survey, the size of the agricultural population covered by the survey, and any different wage structures in the crop activity or agricultural activity within the State. *		Yes No
3a. Explain how the surveyor determined the scope of the geographic area to survey. *
4. For the geographic area, the surveyor (mark only one): * Attempted to contact all employers employing workers in the crop activity or agricultural activity and distinct work task(s), if applicable Contacted a randomized sample of such employers Contacted all such employers (required where the estimated universe of employers in item C.4b is less than 5) None of the above
4a. Name of the source(s) used to identify the employers that employ U.S workers in the crop activity or agricultural activity and distinct work task(s), if applicable, and geographic area surveyed: *
4b. Estimated number of employers identified through the source(s) in item C.4a: *	4c. Estimated number of U.S. workers identified through the source(s) in item C.4a: *
5. The survey reports the average wage of U.S. workers in the crop activity or agricultural activity and distinct work task(s), if applicable, and geographic area using the unit of pay used to compensate the largest number of U.S. workers whose wages are reported in the survey. *		Yes No
5a. Identify the unit of pay used to compensate the largest number of U.S. workers in the crop activity or agricultural activity and distinct work task(s), if applicable, and geographic area surveyed. *
6. If item C.4c is at least 30, the survey includes the wages of at least 30 U.S. workers in the unit of pay in item C.5a, OR If item C.4c is less than 30, the survey includes the wages of all such U.S. workers. *		Yes No
7. If item C.4b is at least 5, the survey includes wages of U.S. workers employed by at least 5 employers in the unit of pay in item C.5a, OR If item C.4b is less than 5, the survey includes the wages of U.S. workers employed by all such employers. *		Yes No
8. If item C.4b is at least 4, the wages paid by a single employer represent no more than 25 percent of sampled wages in the unit of pay in item C.5a. * (Not applicable if the estimated universe of employers in item C.4b is less than 4.)		Yes No N/A

For Public Burden Statement, see the Instructions for Form ETA-232.

Form ETA-232 FOR DEPARTMENT OF LABOR USE ONLY Page 3 of 3