Regulations Governing the Administration of the Longshore and Harbor Workers' Compensation Act

ICR 200309-1215-001

OMB: 1215-0160

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
1215-0160 200309-1215-001
Historical Active 200010-1215-003
DOL/ESA
Regulations Governing the Administration of the Longshore and Harbor Workers' Compensation Act
Extension without change of a currently approved collection   No
Regular
Approved without change 12/04/2003
Retrieve Notice of Action (NOA) 09/26/2003
The request not to display the expiration date on the forms is approved.
  Inventory as of this Action Requested Previously Approved
12/31/2006 12/31/2006 12/31/2003
170,564 0 189,144
64,437 0 76,326
57,000 0 59,000

The regulations and forms cover the submission of information relating to the processing of claims for benefits under the Longshore Act and extensions.

None
None


No

1
IC Title Form No. Form Name
Regulations Governing the Administration of the Longshore and Harbor Workers' Compensation Act ESA-100, LS-200, LS-271, LS-201, LS-513, LS-267, LS-203, LS-204, LS-262, LS-274

  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 170,564 189,144 0 0 -18,580 0
Annual Time Burden (Hours) 64,437 76,326 0 0 -11,889 0
Annual Cost Burden (Dollars) 57,000 59,000 0 0 -2,000 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.
09/26/2003


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