Information Collection

Payment of Compensation Without Award

IC 13633 under ICR 200805-1215-005 · OMB 1215-0022.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form LS-206 Payment of Compensation Without Award	Form
LS-206 Payment of Compensation without Award ls-206.pdf www.dol.gov/esa/owcp/dlhwc/ls-206.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 702.234

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	LS-206	Payment of Compensation without Award	ls-206.pdf	http://www.dol.gov/esa/owcp/dlhwc/ls-206.pdf	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title: DOL/ESA-15

FR Citation: 58 FR 49599

Number of Respondents: 600

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 1 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	21,000	-3,500	24,500
Annual IC Time Burden (Hours)	5,250	-875	6,125
Annual IC Cost Burden (Dollars)	10,395	-605	11,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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