Form Wh-205 - Application For Authorization To Employ A Student-Learner At Subminimum Wages
Download a blank fillable Form Wh-205 - Application For Authorization To Employ A Student-Learner At Subminimum Wages in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Wh-205 - Application For Authorization To Employ A Student-Learner At Subminimum Wages with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Application for Authorization to
U.S. Department of Labor
Employ A Student-Learner at
Wage and Hour Division
Subminimum Wages
230 South Dearborn Street, Room 514
Chicago, Illinois 60604
OMB No. 1235-0001
Expires: 03-31-2014
Instructions: Form WH-205 is completed by an employer to obtain certification to employ
OFFICIAL USE ONLY
student-learners at wages lower than the Federal minimum wage to prevent curtailment
of opportunities for employment. Submission of this information is voluntary, but failure to
A. Control number
submit the information will prohibit the Wage and Hour Division from authorizing the
B. Effective date
employment of student-learners at subminimum rates. 29 U.S.C. § 214(a); 29 C.F.R. § 520.501.
C. Expiration date
The school officials' certification in Item 27 of the application provides temporary authority to
D. Reviewing official
employ the named student-learner under the terms proposed in the application which are in
accordance with sections 520.502 and .503 of the Student-Learner Regulations (29 C.F.R. Part
520). The authority begins on the date the application is forwarded to the Regional Office of
the Employment Standards Administration. At the end of 30 days, this authority is extended
to become the approved certificate unless the Administrator or his/her authorized represen-
tative denies the application, issues a certificate with modified terms and conditions, or ex-
pressly extends the period of review. Note that the certificate is valid for no more than 1
school year and does not extend beyond the date of graduation.
READ CAREFULLY THE INSTRUCTIONS FOR COMPLETING THIS FORM. PRINT OR TYPE ALL ANSWERS
1. Name and address, including zip code, of Establishment making
3A. Name and address of student-learner:
application:
B. Date of birth: (Month, Day, Year)
2. Type of business and products manufactured, sold, or services
rendered:
4. Name and address, including zip code, of school in which student-
learner is enrolled.
5. Proposed beginning date of employment
(Month, Day, Year)
6. Proposed ending date of employment
(Month, Day, Year)
7. Proposed graduation date (Month, Day, Year)
17. Title of student-learner occupation:
18. Number of employees in this establishment
8. Number of weeks in school year
9. Total hours of school instruction per week
19. Number of experienced employees in
student-learner's occupation
10. Number of school hours directly related to
20. Minimum hourly wage rate of experienced
employment training
workers in item 19
11. How is employment training scheduled
21. Subminimum wage(s) to be paid student-learner
(if a progressive wage schedule is proposed, enter each rate and
(weekly, alternate weeks, etc.)?
specify the period during which it will be paid):
12. Number of weeks of employment training at
subminimum wages
13. Number of hours of employment training a week
22. Is an age or Employment Certificate on file in this establishment for
this student-learner? (If not, see instructions).
14. Are Federal Vocational Education Funds being used
for this program?
Yes
No
15. Was this program authorized by the State Board of
Vocational Education?
16. If the answer to item 15 is ''No'', give the name of the recognized
23. Is it anticipated that the student-learner will be employed in the
performance of a government contract subject to the Walsh-Healey
educational body which approved this program:
Public Contracts Act or the Service Contract Act?
Yes
No
Form WH-205
ATTACH SEPARATE PAGES IF NECESSARY
Rev. December 2010
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Wh-226 - Application For Authority To Employ Workers With Disabilities At Special Minimum Wages - 2008
Legal
Form Wh-202 - Application For Authority To Employ Six Or Fewer Full-time Students At Subminimum Wages In Retail Or Service Establishments Or Agriculture Under Regulations 29 C.f.r. Part 519
Legal
Wh-226a - Supplemental Data Sheet For Application For Authority To Employ Workers With Disabilities At Special Minimum Wages
Business
Form Mllp-12 - Application For Authority To Do Business For A Foreign Limited Liability Partnership - Maine Secretary Of State
Legal
Form Mbca-12 - Application For Authority To Do Business For A Foreign Business Corporation - 2016
Legal
Form Fda 766 - Application For Authorization To Relabel Or To Perform Other Action Of The Federal Food, Drug, And Cosmetic Act And Other Related Acts
Legal
Form 11 - Nebraska Application For Permission To File A Monthly Combined Sales And Use Tax Or A Combined Annual Litter Fee Return
Financial
Related Categories
Parent category: Legal