Record of Employee Interview - NDC Construction NDC Contruction

Getting It Done With... Employees

Record of Employee Interview

U.S. Department of Housing and Urban Development
Office of Labor Relations
OMB Approval No. 2501-0009
(exp. 09/30/2017)

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 of information. This agency may not collect this information, and you are not required to complete this form unless it displays a currently valid OMB control number. The information is collected to ensure compliance with the Federal labor standards by recording interviews with construction workers. The information collected will assist HUD in the conduct of compliance monitoring; the information will be used to test the veracity of certified payroll reports submitted by the employer. Sensitive Information. The information collected on this form is considered sensitive and is protected by the Privacy Act. The Privacy Act requires that these records be maintained with appropriate administrative, technical, and physical safeguards to ensure their security and confidentiality. In addition, these records should be protected against any anticipated threats or hazards to their security or integrity that could result in substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom the information is maintained. The information collected herein is voluntary, and any information provided shall be kept confidential.

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  • 1. Project Information

  • 2. Employee Details

  • 3. Job Duration details

  • MM slash DD slash YYYY
  • 4. Payment Details

  • 4b. Fringe Benefits/¿Beneficios complementarios?
  • Job Details

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • Payroll Examination/Examinación de Nómina

  • MM slash DD slash YYYY
Form HUD-11 (08/2004)