Application for Special Industrial Homeworker's Certificate

Fair Labor Standards Act Special Employment Provisions

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1235-0001 can be found here:

Documents and Forms

Document Name Document Type
Form WH-2 Application for Special Industrial Homeworker's Certificate Form and Instruction
INSTRUCTIONS For FORM WH-2 and WH-46.docx www.dol.gov/agencies/whd/forms/wh2-wh46 Instruction
INSTRUCTIONS For FORM WH-2 and WH-46.docx www.dol.gov/agencies/whd/forms/wh2-wh46 Instruction
WH-2 Application for Special Industrial Homeworker's Certific WH-2.pdf www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-2.pdf Form and Instruction
WH-2 Application for Special Industrial Homeworker's Certific WH-2.pdf www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-2.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Application for Special Industrial Homeworker's Certificate	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 530.1-.4

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	WH-2	Application for Special Industrial Homeworker's Certificate	WH-2.pdf	https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-2.pdf	Yes	No	Fillable Printable
Instruction			INSTRUCTIONS For FORM WH-2 and WH-46.docx	https://www.dol.gov/agencies/whd/forms/wh2-wh46	Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1	0	1
Annual IC Time Burden (Hours)	1	0	1
Annual IC Cost Burden (Dollars)	0	-3	3

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.