INSTRUCTIONS FOR WH-226A SUPPLEMENTAL DATA SHEET FOR APPLICATION FOR AUTHORITY TO EMPLOY WORKERS
WITH DISABILITIES AT SUBMINIMUM WAGES
Initial Applicants
Initial applicants must submit a WH-226A for each work site counted in Item 6 of the WH-226, including the main establishment. Items 1-5 of the
WH-226A must be completed. Any remaining items on the WH-226A must be completed if the information is available at the time of application.
Renewal Applicants
Renewal applicants must submit a complete WH-226A for each work site counted in Item 6 of the WH-226, including the main establishment.
All items on the WH-226A must be completed.
ITEM INSTRUCTIONS
Item 1
Provide the name of the establishment / work site covered by this form. Remember that the main establishment is also considered a work site if
workers are employed there at subminimum wages.
Item 2
Provide the physical address of the establishment / work site.
Item 3
Indicate whether the work site is the main establishment, a branch establishment, an off-site work location, or a School Work Experience Program
work site.
Main Establishment: The primary location of the employer that files this application on behalf of all its associated work sites. (There can only be
one main establishment.)
Branch Establishments: A branch establishment is a physically separate work site that is part of the same organization as the main
establishment.
Off-site Work Location: An off-site work location is a work site typically on the premises of a separate establishment, where workers with
disabilities, or a group of workers with disabilities, are placed in work settings along with job coaches (staff of the rehabilitation or work center).
School Work Experience Program (SWEP): A school-operated program in which students with disabilities may be placed in jobs with private
industry within the community. School employers are responsible for compliance with all applicable child labor laws, minimum wage standards,
and certificate and recordkeeping requirements. The school may submit a group application which covers all students with disabilities and all of
the business locations at which the students will be placed.
Item 4
Mark “yes” if the employer has a Service Contract Act (SCA)-covered contract to provide services to the Federal Government and work under that
contract is performed at this work site.
Item 5
Mark “yes” if the employer has a contract with the Federal Government for services or concessions that was entered into on or after January 1,
2015, which indicates that the contract may be subject to Executive Order 13658 (Establishing a Minimum Wage for Contractors).
Item 6
Count all employees who were paid subminimum wages and performed work at this work site during the most recently completed fiscal quarter that
ended on the date provided in Item 7(a) of the WH-226. Include workers who were employed for less than the full fiscal quarter, i.e. three-month period.
Item 7
Provide the following information for every employee counted in Item 7. The employer may use additional pages of this chart, attach a printed
spreadsheet, or submit this information in another format.
(a) Provide the full name of the worker.
(b) If the worker performed more than one job at this work site during the most recently completed fiscal quarter, provide the total number of jobs
performed.
(c) Provide the average (mean) number of hours per week the employee worked on all jobs at this work site during the most recently completed
fiscal quarter. Calculate this by taking the total number of hours the employee worked during the most recently completed three-month fiscal
quarter and dividing by the number of weeks in the quarter (13 weeks). For example: 260 hours worked in the quarter ÷ 13 weeks per quarter =
20 hours per week average.
(d) Average earnings are computed by dividing the total earnings of the individual worker by the total number of hours worked during the most
recently completed fiscal quarter. Note: The total number of hours worked should only include the compensable work time (for example, generally
would not include time spent in rehabilitation, therapy, etc.). For example, John Jones earned $900 during the fiscal quarter and he worked 300
hours. $900 ÷ 300 hours = $3.00 per hour, therefore, Mr. Jones’s average earnings per hour are $3.00.
For Items 7(e) – 7(j), provide the following information for the work performed in the most recently completed fiscal quarter. If the worker performed more
than one job at this work site at a subminimum wage, provide the following information for the job for which this worker worked the most number of hours in
the most recently completed fiscal quarter. For example, John Jones performed three jobs over the last quarter: contract for assembling bolts totaling 65
hours, contract for assembling boxes totaling 42 hours, and contract for shredding totaling 25 hours. The employer should provide responses to 7(e) – 7(j)
for Mr. Jones based on his bolt assembly.
Form WH-226A
REV 12/2016
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