Notice to Employees of Coverage Options under FLSA 18B

Notice to Employees of Coverage Options Under Fair Labor Standards Act Section 18B

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0149 can be found here:

Documents and Forms

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Information Collection (IC) Details

IC Title:	Notice to Employees of Coverage Options under FLSA 18B	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,160,461	Number of Respondents for Small Entity: 5,800,000

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

Percentage of Respondents Reporting Electronically: 38 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	72,484,292	72,484,292
Annual IC Time Burden (Hours)	374,502	374,502
Annual IC Cost Burden (Dollars)	12,229,992	12,229,992

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.