Application For a Farm Labor Contractor Employee Certification of Registration

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⚠️ Notice: This information collection may be referencing outdated material.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 WH-535 Application For a Farm Labor Contractor Employee Certification of Registration Form
Edits to Instruction Page on Website 2.16.21.docx Instruction
Edits to Instruction Page on Website 2.16.21.docx Instruction
WH-535 APPLICATION FOR A FARM LABOR CONTRACTOR EMPLOYEE CERTIFI WH-535 - FLCE_clean.docm Form
WH-535 APPLICATION FOR A FARM LABOR CONTRACTOR EMPLOYEE CERTIFI WH-535 - FLCE_clean.docm Form
WH-535 SOLICITUD DE CERTIFICADO DE REGISTRO DE EMPLEADO DE CONT WH-535 FLCE Form SPANISH.docm Form
WH-535 SOLICITUD DE CERTIFICADO DE REGISTRO DE EMPLEADO DE CONT WH-535 FLCE Form SPANISH.docm Form

Information Collection (IC) Details

IC Title:	Application For a Farm Labor Contractor Employee Certification of Registration	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	WH-535	APPLICATION FOR A FARM LABOR CONTRACTOR EMPLOYEE CERTIFICATE OF REGISTRATION	WH-535 - FLCE_clean.docm	Yes	No	Fillable Printable
Form	WH-535	SOLICITUD DE CERTIFICADO DE REGISTRO DE EMPLEADO DE CONTRATISTA DE TRABAJO AGRÍCOLA	WH-535 FLCE Form SPANISH.docm	Yes	No	Fillable Printable
Instruction			Edits to Instruction Page on Website 2.16.21.docx	Yes	No	Printable Only

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: 12,033	Number of Respondents for Small Entity: 11,191

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12,033	12,033
Annual IC Time Burden (Hours)	6,017	6,017
Annual IC Cost Burden (Dollars)	57,688	57,688

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.