OMB control number

Disclosures to Workers Under the Migrant and Seasonal Agricultural Worker Protection Act

OMB 1235-0002 · DOL/WHD.

OMB 1235-0002

Agricultural employers, associations and farm labor contractors use this information collection to disclose employment terms and conditions, wage statements, and housing terms and conditions to migrant/seasonal agricultural workers, to comply with the Migrant Seasonal Agricultural Worker Protection Act.

The latest form for Disclosures to Workers Under the Migrant and Seasonal Agricultural Worker Protection Act expires 2027-01-31 and is listed under ICR 202210-1235-003.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form WH-521 Housing Terms and Conditions for Migrant Agricultural Workers	Form and Instruction
Form WH-501 English Migrant and Seasonal Agricultural Worker Protection Wage Statement	Form
Form WH-516 Worker Information - Terms and Conditions of Employment	Form and Instruction
WH-516 Summary of edits v1.0 (2022-12-12).docx	Supplementary Document
WH-521 Summary of edits v1.0 (2022-12-12).docx	Supplementary Document
SS 1235-0002 v4 (2023-08-01).docx	Supporting Statement A
FLC Hourly Wage 2022 (BLS).pdf	Supplementary Document
60-day Notice (2023-03-10).pdf	Supplementary Document
WH-521 Proposed Revisions v1.1 (2022-12-08).docx	Supplementary Document
WH-516 Proposed Revisions v1.1 (2022-12-08).docx	Supplementary Document
NAWS Research Report 16.pdf	Supplementary Document
Census of Agriculture 2017.pdf	Supplementary Document
Housing Terms and Conditions for Migrant Agricultural Workers	Form and Instruction
Migrant and Seasonal Agricultural Worker Protection Wage Statement	Form
Worker Information - Terms and Conditions of Employment	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202210-1235-003	Revision of a currently approved collection	2023-08-09	Approved without change
202001-1235-002	Revision of a currently approved collection	2020-08-10	Approved without change
201701-1235-002	Extension without change of a currently approved collection	2017-06-30	Approved without change
201312-1235-001	Revision of a currently approved collection	2014-05-12	Approved without change
201210-1235-001	No material or nonsubstantive change to a currently approved collection	2012-10-24	Approved without change
201007-1235-002	Revision of a currently approved collection	2011-02-24	Approved without change
201003-1235-002	Extension without change of a currently approved collection	2010-03-12	Approved without change

OMB Details

Worker Information - Terms and Conditions of Employment

Federal Enterprise Architecture: Workforce Management - Labor Rights Management

Information collection instruments
Form	Name	Electronic access	Type
Form WH-516	Worker Information- Terms and Conditions of Employment	www.dol.gov/sites/dolgov/files/WHD/legacy/files/wh516.pdf	Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.