Pre-Hearing Statement

Longshore and Harbor Workers' Compensation Act Pre-Hearing Statement

OMB: 1240-0036

IC ID: 13760

Information Collection (IC) Details

View Information Collection (IC)

Pre-Hearing Statement
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 702.317

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form LS-18 Pre-Hearing Statement ls-18.pdf https://www.dol.gov/owcp/dlhwc/ls-18.pdf Yes Yes Fillable Fileable

Income Security General Retirement and Disability

DOL/GOVT-15  67 FR 16870

3,513 0
   
Individuals or Households
 
   13 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,513 0 0 413 0 3,100
Annual IC Time Burden (Hours) 586 0 0 59 0 527
Annual IC Cost Burden (Dollars) 1,742 0 0 340 0 1,402

Title Document Date Uploaded
DLHWC SEA Portal DLHWC Seaportal.pdf 09/24/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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