Information Collection Request
Employment Information Form
ICR 202402-1235-001 · OMB 1235-0021 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1235-0021 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form WH-3-Sp Employment Information Form |
Form and Instruction | Modified | Repair queued |
 Supporting Statement 1235-0021 v3.1 (2024-04-03)_MN.docx |
Supporting Statement A | Uploaded 2024-04-04 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 13616 |  Employment Information Form |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DOL/WHD |
| OMB Control No | 1235-0021 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202211-1235-001 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |