Longshore and Harbor Workers' Compensation Act Pre-Hearing Statement

ICR 201506-1240-010

OMB: 1240-0036

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Justification for No Material/Nonsubstantive Change
2014-12-18
Justification for No Material/Nonsubstantive Change
2014-09-30
Supplementary Document
2014-03-04
Supplementary Document
2014-03-04
Supporting Statement A
2014-06-19
IC Document Collections
IC ID
Document
Title
Status
13760 Modified
ICR Details
1240-0036 201506-1240-010
Historical Active 201409-1240-006
DOL/OWCP
Longshore and Harbor Workers' Compensation Act Pre-Hearing Statement
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 06/05/2015
Retrieve Notice of Action (NOA) 06/05/2015
  Inventory as of this Action Requested Previously Approved
08/31/2017 08/31/2017 08/31/2017
3,100 0 3,100
527 0 527
1,402 0 1,612

Form LS-18 is used to refer cases to the Office of Administrative Law Judges for formal hearing under the Longshore and Harbor Workers' Compensation Act.

US Code: 33 USC 901 Name of Law: Longshore and Harbor Workers' Compensation Act
  
None

Final or interim final rulemaking 80 FR 12917 03/12/2015

  79 FR 12226 03/04/2014
79 FR 36098 06/25/2014
No

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

  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 3,100 3,100 0 0 0 0
Annual Time Burden (Hours) 527 527 0 0 0 0
Annual Cost Burden (Dollars) 1,402 1,612 0 -210 0 0
No
No
There is a decrease of 357 burden hours since the last clearance submission due to a decrease in reporting under the Act. There has been a change in the operation and maintenance cost from $2,444 to $1,512 (-832) due to a decrease in reporting under the Act.

$9,685
No
No
No
No
No
Uncollected
Cheryl Jordan 202 693-0289 [email protected]

  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.
03/12/2015


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