Forms

WH-2 & WH-46: Industrial homework

• WH-2 & WH-46 Forms & Instructions

WH-4: H-1B Nonimmigrant Information Form

• WH-4 Form & Instruction

WH-5: Certificate of Training Form

• WH-5 (PDF)

WD-10: DBRA Report of Construction Contractor’s Wage Rates

• WD-10 Instructions
• WD-10

WH-75: Homeworker Handbook

• WH-75 (PDF)
• WH-75 Spanish (PDF)

WH-200, WH-201, and WH-202: Applications for Authority to Employ Full-Time Students at Subminimum Wages Under Regulations 29 CFR Part 519

• WH-200, WH-201, and WH-202 Forms & Instructions

WH-205: The Payment of Subminimum Wages to Student-Learners Under Section 14(a) of the FLSA

• WH-205 Form & Instruction

WH-226: Application to Employ Workers with Disabilities at Special Minimum Wages

• Online Section 14(c) Certificate Application
• WH-226 & WH-226A Forms & Instructions

WH-347: DBRA Certified Payroll Form

• Revised WH-347 Form & Instruction Applicable to Contracts Entered into Pursuant to Invitations for Bids Issued or Negotiations Concluded On or After January 18, 2009.

WH-380-E: FMLA Certification of Health Care Provider for Employee’s Serious Health Condition

• WH-380-E (PDF)
• WH-380-E Spanish (PDF)

WH-380-F: FMLA Certification of Health Care Provider for Family Member’s Serious Health Condition

• WH-380-F (PDF)
• WH-380-F Spanish (PDF)

WH-381: FMLA Notice of Eligibility and Rights & Responsibilities

• WH-381 (PDF)
• WH-381 Spanish (PDF)

WH-382 : FMLA Designation Notice

• WH-382 (PDF)
• WH-382 Spanish (PDF)

WH-384 : FMLA Certification of Qualifying Exigency For Military Family Leave

• WH-384 (PDF)
• WH-384 Spanish (PDF)

WH-385: FMLA Certification for Serious Injury or Illness of Covered Servicemember -- for Military Family Leave

• WH-385 (PDF)
• WH-385 Spanish (PDF)

WH-385V: FMLA Certification for Serious Injury or Illness of a Veteran for Wage and Hour Division Military Caregiver Leave

• WH-385V (PDF)
• WH-385V Spanish (PDF)

WH-501: MSPA Wage Statement

• WH-501 (PDF)
• WH-501 Spanish (PDF)

WH-514: MSPA Vehicle Mechanical Inspection Report for Transportation Subject to Department of Transportation Requirements

• WH-514 (PDF)

WH-514A: MSPA Vehicle Mechanical Inspection Report for Transportation Subject to Department of Labor Safety Standards

• WH-514A (PDF)

WH-515: MSPA Doctor’s Certificate

• WH-515 (PDF)

WH-516: MSPA Worker Information – Terms of Employment

• WH-516 (PDF)
• WH-516 Spanish (PDF)
• WH-516 Haitian Creole (PDF)

WH-520: MSPA Housing Occupancy Certificate

• WH-520 (PDF)

WH-521: MSPA Housing Terms and Conditions

• WH-521 (PDF)

WH-530: MSPA Application for a Farm Labor Contractor or Farm Labor Contractor Employee Certificate of Registration

• WH-530 Form & Instruction

WH-1481: EPPA Notice to Examinee

• WH-1481(PDF)

IMPORTANT! This webpage contains important information about your workplace rights and responsibilities provided by the Wage and Hour Division. It is critical that you understand the information on this webpage, and we will provide the information in your preferred language at no cost to you. To request translation or interpreting services call 1-866-487-9243 or email WHDNOComm@dol.gov.

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