OMB control number

Disclosures to Workers Under the Migrant and Seasonal Agricultural Worker Protection Act

OMB 1235-0002 · DOL/WHD.

OMB 1235-0002

Agricultural employers, associations and farm labor contractors use this information collection to disclose employment terms and conditions, wage statements, and housing terms and conditions to migrant/seasonal agricultural workers, to comply with the Migrant Seasonal Agricultural Worker Protection Act.

The latest form for Disclosures to Workers Under the Migrant and Seasonal Agricultural Worker Protection Act expires 2027-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form WH-521 Housing Terms and Conditions for Migrant Agricultural Workers Form and Instruction
Form WH-501 English Migrant and Seasonal Agricultural Worker Protection Wage Statement Form
Form WH-516 Worker Information - Terms and Conditions of Employment Form and Instruction
WH-516 Summary of edits v1.0 (2022-12-12).docx Supplementary Document
WH-521 Summary of edits v1.0 (2022-12-12).docx Supplementary Document
SS 1235-0002 v4 (2023-08-01).docx Supporting Statement A
FLC Hourly Wage 2022 (BLS).pdf Supplementary Document
60-day Notice (2023-03-10).pdf Supplementary Document
WH-521 Proposed Revisions v1.1 (2022-12-08).docx Supplementary Document
WH-516 Proposed Revisions v1.1 (2022-12-08).docx Supplementary Document
NAWS Research Report 16.pdf Supplementary Document
Census of Agriculture 2017.pdf Supplementary Document
Housing Terms and Conditions for Migrant Agricultural Workers Form and Instruction
Migrant and Seasonal Agricultural Worker Protection Wage Statement Form
Worker Information - Terms and Conditions of Employment Form and Instruction

All Historical Document Collections

202210-1235-003 Approved without change	Revision of a currently approved collection	2023-08-09
202001-1235-002 Approved without change	Revision of a currently approved collection	2020-08-10
201701-1235-002 Approved without change	Extension without change of a currently approved collection	2017-06-30
201312-1235-001 Approved without change	Revision of a currently approved collection	2014-05-12
201210-1235-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2012-10-24
201007-1235-002 Approved without change	Revision of a currently approved collection	2011-02-24
201003-1235-002 Approved without change	Extension without change of a currently approved collection	2010-03-12

OMB Details

Worker Information - Terms and Conditions of Employment

Federal Enterprise Architecture: Workforce Management - Labor Rights Management

Form WH-516

Worker Information- Terms and Conditions of Employment

www.dol.gov/sites/dolgov/files/WHD/legacy/files/wh516.pdf

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.