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September 23, 2008    DOL Home > Find It! By Form > DOL Form   

DOL Form WH-226

View ESA-WHD's Form 1215-0005 Online htm
Agency: ESA-WHD
Title: Application for Authority to Employ Workers with Disabilities at Special Minimum Wages
Form Description: This is an application for the authority to employ workers with disabilities at special minimum wage rates under the Fair Labor Standards Act (FLSA), Walsh- Healey Public Contracts Act (PCA), or McNamara-O’Hara Service Contract Act (SCA).
OMB Control Number: 1215-0005
OMB Expiration Date: Monday, January 31, 2011

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