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USDOLRev. 07-2020

Official form guide

Form WH-501: Application for Certificate to Employ Workers with Disabilities Under Section 14(c)

Application for a certificate allowing employers to pay subminimum wages to workers with disabilities under Section 14(c) of the Fair Labor Standards Act.

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Form Overview

DOL Form WH-501 - Application for Certificate to Employ Workers with Disabilities Under Section 14(c)

Application for a certificate allowing employers to pay subminimum wages to workers with disabilities under Section 14(c) of the Fair Labor Standards Act.

A certificate allowing payment of subminimum wages calculated as a percentage of prevailing wage rates, commensurate with the worker's productivity.

Risk Radar

Scan points
  • 1Failing to conduct proper prevailing wage surveys — certificates require accurate comparative data.
  • 2Not completing individual worker assessments — wages must be calculated individually, not as a blanket policy.
  • 3Missing annual renewal deadlines — expired certificates mean all workers must be paid at least minimum wage.

Plain English

This form lets organizations apply for a certificate to pay workers with disabilities wages below the federal minimum wage, calculated based on their productivity compared to workers without disabilities.

Submission Date

  • Filing date: Apply before employing workers with disabilities at subminimum wages. Certificates must be renewed annually.
  • Preparation window: collect IDs, supporting records, and signatures in advance.
  • Final review: verify names, dates, and required fields before submission.

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Glossary Terms

paymentminimumfederallabor

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Field map

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8 fields

Employer Info

3 items

Employer Name

Legal name of the employing organization.

Requiredtext
Address

Principal place of business.

Requiredtext
FEIN

Federal Employer Identification Number.

Requiredein

Operations

2 items

Type of Work Performed

Description of work performed by workers with disabilities.

Requiredtext
Number of Workers with Disabilities

Total number of workers to be covered by the certificate.

Requiredtext

Wages

2 items

Prevailing Wage Rate

The wage rate paid to workers without disabilities for comparable work.

Requiredamount
Productivity Assessment Method

Method used to determine commensurate wage rates.

Requiredtext

Signature

1 items

Authorized Signature

Signature of authorized company official.

Requiredsignature

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Quick Facts

Employers and sheltered workshops seeking a Section 14(c) certificate to employ workers with disabilities at commensurate wages.
A certificate allowing payment of subminimum wages calculated as a percentage of prevailing wage rates, commensurate with the worker's productivity.
Apply before employing workers with disabilities at subminimum wages. Certificates must be renewed annually.
Submit to the Wage and Hour Division office serving your area.
FLSA Section 14(c) allows employers to pay commensurate (productivity-based) wages to workers whose disabilities impair their productive capacity for the work being performed.
Complete the application with detailed information about your organization, the work performed, and your wage methodology. WHD will conduct a review.

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Copyright & Licensing - US Government Forms

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Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
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