OMB control number

Records to be kept by Employers - Fair Labor Standards Act (FLSA)

OMB 1235-0030 · DOL/WHD.

OMB 1235-0030

Latest Forms, Documents, and Supporting Material

Document Name
Form WH-14 Application for Federal Certificate of Age Form and Instruction
Form WH-5 Written Agreements to Claim Agricultural Student Learner Exemption to Youth Employment Restrictions Form and Instruction
SS 1235-0030 11162020.docx Supporting Statement A
29 CFR Parts 500 - 870.pdf Supplementary Document
29 USC Sections 201 - 219.pdf Supplementary Document
Tip Regulations Under the Fair Labor Standards Act NPRM (1235-0018) (published).pdf Supplementary Document
Minimum Age Standards - Parental Consent
Application for Authorized Basic Rate
Records When Claiming Partial Overtime Exemption for Remedial Education
Requirements of a Bona Fide Thrift or Savings Plan and a Bona Fide Profit Sharing Plan or Trust
Recording Schools with WECEP students
WECEP Written Training Agreement
Work Experience and Career Exploration Program (WECEP)
Waiver of Child Labor Provisions for Agricultural Employment of 10 and 11-year-old Minors in Hand Harvesting of Short Season Crops
Application for Federal Certificate of Age Form and Instruction
General FLSA Records (Public Sector)
Written Agreements to Claim Agricultural Student Learner Exemption to Youth Employment Restrictions Form and Instruction
Written Agreements to Claim Non-Agricultural Student Learner Exemption to Youth Employment Restrictions
Records on State/Local Government Employees Receiving Compensatory Time
Records on Workers with Disabilities and Patient Workers Paid Sub-Minimum Wages
Records on Messengers and Student Learners Paid Sub-Minimum Wages
Records on Full-time Students Paid Sub-Minimum Wages
Records on Certain Agricultural Emloyees (Employees)
Records on Certain Agricultural Employees (Employers)
Records on Tipped Employees
Records When Paying Overtime on an "Applicable" or "Authorized" Basic Rate
Records for Overtime Payments Based on Trip Rate Plans
Petitions for Review and Reconsideration
General FLSA Records (Private Sector)

All Historical Document Collections

202007-1235-002	New collection (Request for a new OMB Control Number)	2020-12-30
201908-1235-001 Comment filed on proposed rule	New collection (Request for a new OMB Control Number)	2019-10-08