Form Wh 516 PDF Details

The Form WH-516 plays a crucial role in safeguarding the rights and working conditions of migrant and seasonal agricultural workers in the United States. Administered by the U.S. Department of Labor's Wage and Hour Division, and bearing an Office of Management and Budget (OMB) number, its existence is necessitated by the Migrant and Seasonal Agricultural Worker Protection Act. This form, which must be provided by employers to their workers, contains comprehensive details about the terms and conditions of employment. These details include the location of employment, duration of work, wage rates, types of crops and activities, transportation and other benefits, and any applicable charges to the workers. Furthermore, it outlines provisions for workers' compensation and unemployment insurance, and for migrant workers, information on housing availability and costs. Additionally, it requires the disclosure of any ongoing or recent labor disputes at the place of employment and any arrangements for commission payments to workers. The provision of this form in languages common to the workers aims to ensure clear communication and understanding of employment terms, thereby reinforcing labor rights and protections. While filling out and submitting Form WH-516 is deemed optional, the act of disclosing employment terms in writing to the workers it aims to protect is not merely a best practice but a mandatory requirement for certain employers. This underscores the form's significance in promoting transparency, accountability, and fairness in the agricultural sector.

QuestionAnswer
Form NameForm Wh 516
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesform 516, wh516 eng, form 516 form, wh516 in spanish form

Form Preview Example

Migrant and Seasonal Agricultural

U.S. Department of Labor

Worker Protection Act

Wage and Hour Division

 

OMB NO: 1235-0002

Expires: 08/31/2020

Worker Information—Terms and Conditions of Employment

1. Place of employment:________________________________________________________________________________________________

2. Period of employment: From _______________________

To ___________________________

3. Wage rates to be paid: $ __________________ per Hour

Piece Rate $____________________ per _______________________

4.Crops and kinds of activities: __________________________________________________________________________________________

5.Transportation or other benefits, if any: __________________________________________________________________________________

________________________________________________________________________________________________________________

Charge(s) to workers, if any: __________________________________________________________________________________________

6.Workers’ compensation insurance provided: Yes ________ No_________

Name of compensation carrier: ________________________________________________________________________________________

Name and address of policyholder(s):___________________________________________________________________________________

________________________________________________________________________________________________________________

Person(s) and phone number(s) of person(s) to be notified to file claim:_________________________________________________________

________________________________________________________________________________________________________________

Deadline for filing claim:______________________________________________________________________________________________

7.Unemployment compensation insurance provided: Yes _________ No___________

8.Other benefits: __________________________________________________________________________ Charge(s) _________________

9.For migrant workers who will be housed, the kind of housing available and cost, if any:_____________________________________________

________________________________________________________________________________________________________________

Charge(s)_________________________________________________________________________________________________________

10.List any strike, work stoppage, slowdown, or interruption of operation by employees at the place where the workers will be employed. (If there are no strikes, etc., enter “None”):

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

11.List any arrangements that have been made with establishment owners or agents for the payment of a commission or other benefits for sales made to workers. (If there are no such arrangements, enter “None”):

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

Name of Person(s) Providing This Information: ______________________________________________________________________________

Note: The Department of Labor–Wage and Hour Division makes this form available in certain other languages to enable employers to satisfy the requirement that the terms and conditions of employment be disclosed in a language common to the workers. Contact the nearest office of the Wage and Hour Division to obtain such forms.

While completion of Form WH516 is optional, it is mandatory for Farm Labor Contractors, Agricultural Employers, and Agricultural Associations to disclose employment terms and conditions in writing to migrant and day-haul workers upon recruitment, and to seasonal workers other than day-haul workers upon request when an offer of employment is made to respond to the information collection contained In 29 CFR §§ 500.75-

500.76.This optional form may be used to disclose the required information. Thereafter, any migrant or seasonal worker has the right to have, upon request, a written statement provided to him or her by the employer, of the information described above. This optional form may also be used for this purpose.

We estimate that it will take an average of 32 minutes to complete this collection of information, including the time to review instructions, search existing data sources, gather and maintain the data needed, and complete and review the collection of information. If you have any comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, send them to the Administrator, Wage and Hour Division, Room S3502, 200 Constitution Avenue NW, Washington, D.C. 20210. Do NOT send the completed form to this office.

Persons are not required to respond to this information unless it displays a currently valid OMB number.

Optional form WH516 ENG REV 06/14

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