Employment Under Special Certificates of Workers with Disabilities at Special Minimum Wages

Fair Labor Standards Act Special Employment Provisions

Documents and Forms

Document Name Document Type
Form WH-226 Employment Under Special Certificates of Workers with Disabilities at Special Minimum Wages Form and Instruction
Instructions for Forms WH-226 & WH-226A.docx www.dol.gov/agencies/whd/forms/wh226 Instruction
WH-226 Application for Authority to Employ Workers with Disabil Form WH-226 Application for Authority to Employ Workers with Disabilities at Subminimum Wages.pdf www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-226.pdf Form and Instruction
WH-226A Supplemental Data Sheet for Application for Authority to Form WH-226A Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilties at Subminimum Wages.pdf www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-226A.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Employment Under Special Certificates of Workers with Disabilities at Special Minimum Wages	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 525.11-.13 29 CFR 525.7-.9

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	WH-226	Application for Authority to Employ Workers with Disabilities at Subminimum Wages	Form WH-226 Application for Authority to Employ Workers with Disabilities at Subminimum Wages.pdf	https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-226.pdf	Yes	No	Fillable Printable
Form and Instruction	WH-226A	Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilities at Subminimum Wages	Form WH-226A Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilties at Subminimum Wages.pdf	https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-226A.pdf	Yes	No	Fillable Printable
Instruction			Instructions for Forms WH-226 & WH-226A.docx	https://www.dol.gov/agencies/whd/forms/wh226	Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 441	Number of Respondents for Small Entity: 441

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

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,668	-23	1,691
Annual IC Time Burden (Hours)	3,005	-19	3,024
Annual IC Cost Burden (Dollars)	2,217	-26	2,243

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.