Forms

In order to access a form you MUST select the form name and then select the Save link as. to save it to your documents folder. Then edit from there.

WH-2 & WH-46: Industrial homework

WH-4: H-1B Nonimmigrant Information Form

WH-5: Certificate of Training Form

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

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

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

WH-515: MSPA Doctor’s Certificate

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-521: MSPA Housing Terms and Conditions

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

WH-1481: EPPA Notice to Examinee

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 .