Pre-Hearing Statement

ICR 199602-1215-007

OMB: 1215-0085

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
13757 Migrated
ICR Details
1215-0085 199602-1215-007
Historical Active 199303-1215-001
DOL/ESA
Pre-Hearing Statement
Extension without change of a currently approved collection   No
Regular
Approved without change 04/29/1996
Retrieve Notice of Action (NOA) 02/29/1996
Approved; DOL response of 4/23/96 accepted.
  Inventory as of this Action Requested Previously Approved
05/31/1999 05/31/1999 04/30/1996
6,800 0 6,800
1,088 0 1,088
3,000 0 0

This form is used to refer cases to the Office of the Administrative Law Judge for formal hearing under the Longshore and Harbor Workers' Compensation Act.

None
None


No

1
IC Title Form No. Form Name
Pre-Hearing Statement LS-18

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 6,800 6,800 0 0 0 0
Annual Time Burden (Hours) 1,088 1,088 0 0 0 0
Annual Cost Burden (Dollars) 3,000 0 0 3,000 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/29/1996


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