OMB control number
Employee Polygraph Protection Act
OMB 1235-0005 · DOL/WHD.
OMB 1235-0005
These third-party notifications and recordkeeping requirements help ensure polygraph examinees receive the protections and rights provided by the Employee Polygraph Protection Act (EPPA).
The latest form for Employee Polygraph Protection Act expires 2026-10-31 and can be found here.
Latest Forms, Documents, and Supporting Material
Document Name |
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Form |
Supplementary Document |
Supporting Statement A |
Supplementary Document |
Form WH-1481 Notice to Examinee Applicable to Certain Ongoing Investigations, Security Services, and Security of Controlled Substances
1235 - 0005 Calculations.xlsx
SS 1235-0005 v3.6 (2023-08-31).docx
60-day FR Notice 1235-0005 (2023-02-28).pdf
Test Results Written Report and Test Record Maintenance--Employer All Historical Document Collections
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Approved without change |
Extension without change of a currently approved collection | 2023-09-08 | |
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Approved without change |
Extension without change of a currently approved collection | 2020-08-14 | |
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Approved with change |
Extension without change of a currently approved collection | 2017-06-13 | |
|
Approved without change |
Extension without change of a currently approved collection | 2014-09-26 | |
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Approved with change |
Revision of a currently approved collection | 2011-07-22 | |
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Approved without change |
Extension without change of a currently approved collection | 2010-03-12 |
OMB Details
Notice to Examinee Applicable to Certain Ongoing Investigations, Security Services, and Security of Controlled Substances
Federal Enterprise Architecture: Workforce Management - Labor Rights Management
| Form WH-1481 | Notice to Examinee-Employee Polygraph Protection Act | www.dol.gov/whd/forms/wh1481.pdf | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.