DD Form 1919 Wage Data Collection Form

FEDERAL WAGE SYSTEM - WAGE DATA COLLECTION

OMB No. 3206-0036
OMB approval expires Nov 30, 2024

The public reporting burden to complete this information collection is estimated at 1.5 hours per response, including time for reviewing instructions, searching data sources, gathering and maintaining the data needed, and the
completing and reviewing the collected information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number and
expiration date. Send comments regarding this burden estimate or any other aspect of this collection information, including suggestions for reducing this burden to the Department of Defense, ATTN: [email protected]. Current information regarding this collection of information – including all background materials -- can be found at https:/www.reginfo.gov/public/do/PRAMain by using the search function to
enter either the title of the collection (Wage Data Collection Form) or the OMB Control Number (3206-0036)

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION.
1. ESTABLISHMENT NAME

2. WAGE AREA

4a. ESTABLISHMENT JOB TITLE

b. UNION AFFILIATION

3. DATE OF CONTACT
(YYMMDD)
c. ESTABLISHMENT GRADE

5. SURVEY JOB TITLE

6. AREA CODE

7. ESTABLISHMENT
CODE

8. JOB NUMBER

9. FORMAL
RATE
RANGE

10. JOB RATE RANGE
MINIMUM

MAXIMUM

Y or N
12. ESTABLISHED
STEP RATES

13. JOB MATCH

Y = YES
N = NO

14. NUMBER OF
EMPLOYEES

15. STRAIGHT TIME
HOURLY RATE

18. COST OF LIVING
ALLOWANCE
(COLA)

19. BONUS

16. GUARANTEED
MINIMUM

20. LUMP SUM

11. NUMBER OF
ESTABLISHED
STEP RATES

17. INCENTIVE
RATE

21. JOB SUBNUMBER

TOTAL
22. DESCRIPTION OF ESTABLISHMENT JOB

23. DO ABOVE RATES INCLUDE
N or Y

24. REMARKS
AMOUNT

COLA
BONUS
LUMP SUM
SHIFT PA
OTHER ADD-ON
(Explain)
25. SIGNATURE

26. SIGNATURE

PAGE
OF

DD FORM 1919, FEB 2022 (EG)

PREVIOUS EDITION IS OBSOLETE.

PAGES

Office of Personnel Management
Operating Manual, Federal W age System