Information Collection

Application for Federal Certificate of Age

IC 192415 under ICR 202401-1235-001 · OMB 1235-0018.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form WH-14 Application for Federal Certificate of Age	Form and Instruction
WH-14 Application for Federal Certificate of Age wh14 3-1-13.pdf	Form and Instruction
WH-14 Application for Federal Certificate of Age wh14 3-1-13.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 570, Subpart B (To search for a specific CFR, visit the Code of Federal Regulations.)

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-14	Application for Federal Certificate of Age	wh14 3-1-13.pdf		No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 10

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Farms, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

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.