Wage Survey Interview Record

OMB Approval: 1205-0017
Expiration Date: 03/31/2023
                                              Wage Survey Interview Record
                                                    Form ETA-232A
                                               U.S. Department of Labor


Name of the Wage Reporting Area:                                                                 State:
Crop/Agricultural Commodity:
Occupation/Activity:
Name of Employer:
Employer Address:
Active Acreage of Total Production:
Name of Person Interviewed:                                                     Position:
Method of Contact:                                                   Date of the Survey:

1.         Number of U.S. Workers Employed in Crop Activity/Occupation by Wage Rate
          Provide all wage rates, applicable unit of payment (e.g. per hour) and the number of U.S. workers receiving
          each wage as reported by the surveyed employer.

                           Wage Rate(s)                       Unit                  Number of U.S.
                               ($)                     (e.g., per hour)               Workers
                                A                              B                         C

                      $

                      $

                      $
                      $

                      $

                      $

                      $
                      $

                      $


 2.        Productivity and Average Earnings of Piece Rate Workers
           Complete the table below only if the employer reported productivity standards and payments to U.S. workers
           based on piece rates.
                Rate Amount
                                        Number of U.S.        Number of Hours         Total Units of     Average Hourly
                    per Unit
                                             Workers               Worked               Production          Earnings
            Rate(s)          Unit(s)
              A                B                 C                   D                      E                   F
      $                                                                                                   $
      $                                                                                                   $
      $                                                                                                   $
      $                                                                                                   $
      $                                                                                                   $


Page 1 of 4         For more information, visit our Web site at http:// www.foreignlaborcert.doleta.gov       Revised (2020)
OMB Approval: 1205-0017
Expiration Date: 03/31/2023
                                           Wage Survey Interview Record
                                                 Form ETA-232A
                                            U.S. Department of Labor




 3.   Comments
      Describe variables affecting rates, crop conditions or other explanatory and pertinent information:




 4.   State Workforce Agency Point of Contact

      Provide a State Workforce Agency point of contact for the information provided on this form.

       Name:                                                          Title:
       Mailing Address:
       City:                                                          State:                Zip Code:

       Telephone Number:                                              E-mail:




OMB Public Burden Statement – Persons are not required to respond to this collection of information unless it
displays a currently valid OMB control number. Respondents’ obligations to reply to these reporting requirements are
voluntary (20 CFR 653.000 and 20 CFR 655). Public reporting burden for this collection of information is estimated to
average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the collection. Send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S.
Department of Labor, Office of Foreign Labor Certification, Box 12-200, 200 Constitution Avenue, N.W., Washington,
D.C. 20210 (OMB Control Number 1205-0017).


Page 2 of 4      For more information, visit our Web site at http:// www.foreignlaborcert.doleta.gov         Revised (2020)
OMB Approval: 1205-0017
Expiration Date: 03/31/2023
                                          Wage Survey Interview Record
                                                Form ETA-232A
                                           U.S. Department of Labor



                                  WAGE SURVEY INTERVIEW RECORD
                                     GENERAL INSTRUCTIONS
This form shall be completed during the actual prevailing wage survey contacts for transfer to the ETA 232 form. It
should be maintained in a confidential manner since it identifies specific employers and contain information which is
confidential in nature. All items on the form are to be completed with no change in the format. If the space
provided on the form for any item is not adequate, complete information should be provided on a separate attached
sheet, with the item(s) numbered to correspond to those on the form.

Name of the Wage Reporting Area - Enter the name of the wage reporting area and State.

State - Enter the name of the State.

Crop/Agricultural Commodity - Enter all crops or agricultural commodities involved in the survey, i.e., apples,
honey, sheep, etc.

Occupation/Activity - Enter surveyed occupation or activity associated with the crop or commodity identified
above, i.e., harvester, herder, shearer, etc.

Name of Employer - Enter full name of the surveyed employer.

Active Acreage or Total Production - Enter the approximate number of acres of estimated production, etc., (as
appropriate as an indication of the size, or relative significance of the employers operation to the crop activity.

Name of Person Interviewed – Enter full name of the person interviewed

Position – Enter position of the person interviewed

Method of Contact - Indicate the method of contact, i.e., personal visit, telephone contact, etc.

Date of Survey - Enter the date the survey was completed.

Part 1
Number of U.S. Workers in Crop Activity by Rate

Column A. Enter the wage rate.

Column B. Enter on the appropriate lines in Column B the method of payment made to the number of U.S. workers
reported by employers to whom each rate in Column A is applicable.

Column C. Enter on the appropriate lines in Column C the total number of U.S. workers reported by employers to which
each rate in Column B is applicable.


Part 2
Productivity and Average Hourly Earnings of Piece Rate Workers.
Note: Columns A, B, C, D and E may, in some instances, be obtained from payroll records or field tally sheets. Do
not include information pertaining to youth under 16 years of age.

Column A. Enter all wage rates being paid to piece rate workers during the survey period.
Column B. Enter the unit of payment made to the number of U.S. workers reported by employers to whom each rate
          in Column A is applicable.
Column C. Enter the number of U.S. workers reported by employers to whom each rate in Column A is applicable.


Page 3 of 4      For more information, visit our Web site at http:// www.foreignlaborcert.doleta.gov      Revised (2020)
OMB Approval: 1205-0017
Expiration Date: 03/31/2023
                                           Wage Survey Interview Record
                                                 Form ETA-232A
                                            U.S. Department of Labor


Column D. Enter the total number of hours worked by the workers in Column C.
Column E. Enter the total number of units (specified in Column B) produced by the workers in Column C during the
          total hours worked (Column D).
Column F. Enter average hourly earnings based on production.

Part 3
Comments
Enter variables affecting rates, crop conditions, or other explanatory and pertinent information. Describe variables
affecting rates. If a variation in wage rates is reported in Section 1, explain the factors responsible for the variation,
such as differences in yield and field conditions. Also discuss variations in the methods or units of payment.
If a standard schedule of rates applied, attach a copy of the schedule or cross reference to the schedule if previously
submitted.

Other. Use for any pertinent explanation of developments during the survey or reporting period which require
clarification, e.g.:
     - Why no wage finding is made.
     - Increase or decrease in prevailing rate from comparable period of previous year.
     - Factors which will aid the National Office in its interpretation of data.
     - Deviations from standard operating procedures or instructions.
     - Use of weighting procedures to arrive at a prevailing wage finding.
     - Description of perquisite arrangements included in work agreements. Perquisites are not counted as part of
          wages and should not be included in Item 4 of Form ETA – 232.

Part 4
State Workforce Agency Point of Contact

Name - Enter the name of the State Workforce Agency point of contact/person who conducted the interview

Title - Enter the title of the State Workforce Agency point of contact.

Mailing Address - Enter the street address of the State Workforce Agency point of contact.

City - Enter the name of the city of the State Workforce Agency point of contact.

State - Enter the name of the State.

Telephone Number - Enter the area code and telephone number of the State Workforce Agency point of contact.

E-mail - Enter the e-mail address of the State Workforce Agency point of contact in the format
name@emailaddress.top-level domain.

OMB Public Burden Statement: Please Read




Page 4 of 4      For more information, visit our Web site at http:// www.foreignlaborcert.doleta.gov         Revised (2020)