Application to amend a farm labor contractor or farm labor contractor employee certificate of registration, or to request a duplicate certificate

Application for a Farm Labor Contractor or Farm Labor Contractor Employee Certificate of Registration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1235-0016 can be found here:

Documents and Forms

Document Name Document Type
Form WH540 Application to amend a farm labor contractor or farm labor contractor employee certificate of registration, or to request a duplicate certificate Form and Instruction
WH540 APPLICATION TO AMEND A FARM LABOR CONTRACTOR OR FARM LAB WH-540 - Amendment_CLEAN.docm www.dol.gov/sites/dolgov/files/WHD/mspa/wh540.pdf Form and Instruction
WH540 APPLICATION TO AMEND A FARM LABOR CONTRACTOR OR FARM LAB WH-540 - Amendment_CLEAN.docm www.dol.gov/sites/dolgov/files/WHD/mspa/wh540.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Application to amend a farm labor contractor or farm labor contractor employee certificate of registration, or to request a duplicate certificate	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 500.44, -.47

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	WH540	APPLICATION TO AMEND A FARM LABOR CONTRACTOR OR FARM LABOR CONTRACTOR EMPLOYEE CERTIFICATE OF REGISTRATION, OR TO REQUEST A DUPLICATE CERTIFICATE	WH-540 - Amendment_CLEAN.docm	https://www.dol.gov/sites/dolgov/files/WHD/mspa/wh540.pdf	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title: ESA/DOL-34 and ESA/DOL-35	FR Citation: 67 FR 16818

Number of Respondents: 5,835	Number of Respondents for Small Entity: 5,835

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

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,835	-4,165	10,000
Annual IC Time Burden (Hours)	2,918	418	2,500
Annual IC Cost Burden (Dollars)	974	-46,966	47,940

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.