Information Collection

Employer's First Report of Injury or Occupational Disease--LS-202 Physician's Report on Impairment of Vision -- LS-205 Employer's Supplementary Report of Accident or Occupational....

IC 13651 under ICR 199807-1215-007 · OMB 1215-0031.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	Employer's First Report of Injury or Occupational Disease--LS-202 Physician's Report on Impairment of Vision -- LS-205 Employer's Supplementary Report of Accident or Occupational....	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	LS-205	No	No
Form	LS-210	No	No
Form	LS-202	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 29,990	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	29,990	0	-4,410	34,400
Annual IC Time Burden (Hours)	7,543	0	-1,107	8,650
Annual IC Cost Burden (Dollars)	11,000	11,000	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.