Information Collection

Application for Federal Certificate of Age

IC 192415 under ICR 201112-1235-002 · OMB 1235-0018.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1235-0018 can be found here:

Documents and Forms

Document Name Document Type
Form WH-14 Application for Federal Certificate of Age Form and Instruction
WH-14 Application for Federal Certificate of Age wh-14 (Exp 20111130).pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Federal Certificate of Age	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 570, Subpart B (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	WH-14	Application for Federal Certificate of Age	wh-14 (Exp 20111130).pdf		No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 10

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

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

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.