Transcription of WH530 FLC APPLICATION FOR CERTIFICATE OF REGISTRATION
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WH530 FLC APPLICATION FOR CERTIFICATE OF REGISTRATION
WH-530 INITIAL OR RENEWAL APPLICATION FOR A FARM LABOR CONTRACTOR CERTIFICATE OF REGISTRATION ( APPLICATION FOR ORANGE CARD ) Page 1 of 13 WH-530 OMB# 1235-0016 Expiration 09/30/2024 PPlleeaassee rreeaadd iinnssttrruuccttiioonnss bbeeffoorree ccoommpplleettiinngg tthhiiss NNoo FFaarrmm LLaabboorr CCoonnttrraaccttoorr CCeerrttiiffiiccaattee ooff RReeggiissttrraattiioonn mmaayy bbee iissssuueedd uunnlleessss aa ccoommpplleetteedd ffoorrmm hhaass bbeeeenn PPlleeaassee ddoo nnoott ssttaappllee tthhee ffoorrmm oorr aaccccoommppaannyyiinngg Complete this form if you are a ffaarrmm llaabboorr ccoonnttrraaccttoorr,, meaning that you are: a person or business who recruits, solicits, hires, employs, furnishes, or transports migrant or seasonal agricultural workers for money or other benefit; not an agricultural employer, agricultural association, or employee of an agricultural employer or association; and not subject to the exemption criteria found in 29 213(a)(6)(A) and 29 DDoo nnoott ccoommpplleettee tthhiiss ffoorrmm iiff yyoouu aarree aa ffaarrmm llaabboorr ccoonnttrraaccttoorr eemmpplloo
INITIAL OR RENEWAL APPLICATION FOR A FARM LABOR CONTRACTOR CERTIFICATE OF REGISTRATION (APPLICATION FOR “ORANGE CARD”) Page 1 of 13 WH-530 ... (mm/dd/yyyy) Phone number Email address (optional) Proceed to Section 4 3B. INDIVIDUAL OR PROPRIETORSHIP ... ☐ Vehicle liability insurance coverage in the amount of not less than …
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