APPLICATION FOR SPECIAL INDUSTRIAL HOMEWORKER'S CERTIFICATE, APPLICATION FOR AUTHORIZATION TO EMPLOY A STUDENT-LEARNER AT SUBMINIMUM WAGES, & APPLICATION FOR SPECIAL WORKERS, ETC.
ICR 198809-1215-003
OMB: 1215-0005
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1215-0005 can be found here:
APPLICATION FOR SPECIAL
INDUSTRIAL HOMEWORKER'S CERTIFICATE, APPLICATION FOR AUTHORIZATION
TO EMPLOY A STUDENT-LEARNER AT SUBMINIMUM WAGES, & APPLICATION
FOR SPECIAL WORKERS, ETC.
This collection
is approved for one year. These forms shall not be used if new
regulations issued before the expiration date eliminate the need
for, or change the content of, the forms. ESA must include a
disclosure statement on the forms as required at 5 CFR 1320.21.
This disclosure statement shall be included no later than the next
date of reprinting.
Inventory as of this Action
Requested
Previously Approved
12/31/1989
12/31/1989
10/31/1988
19,200
0
25,200
17,433
0
22,673
0
0
0
THE INFORMATION IS NEEDED TO DETERMINE
WHETHER RESPONDENTS WILL BE AUTHORIZED TO PAY SUBMINIMUM WAGES TO
HANDICAPPED INDIVIDUALS AND LEARNERS AND EMPLOY HOMEWORKERS IN THE
RESTRICTED INDUSTRIAL UNDER UNDER THE PROVISIONS OF SECTIONS 11(D),
14(A) AND 14(C) OF THE FAIR LABOR STANDARDS ACT.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.