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Wage and Hour Division
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Wage and Hour Division (WHD)

To order printed copies of forms, please email your request to DOL-WHDPUBLICATIONS@dol.gov

Public Forms

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-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

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

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

WH-382 : FMLA Designation Notice

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

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

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

WH-501: MSPA Wage Statement

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-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


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