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301 Request for Assistance from Department of Labor, EBSA (S
Request for Assistance from the Department of Labor, Employee Benefits Security Administration
Request for Assistance Paper Option (Spanish)
Customer Service Intake Form
OMB: 1210-0146
OMB.report
DOL/EBSA
OMB 1210-0146
ICR 202011-1210-003
IC 198333
301 Request for Assistance from Department of Labor, EBSA (S
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1210-0146 can be found here:
2024-02-23 - Extension without change of a currently approved collection
2022-07-18 - No material or nonsubstantive change to a currently approved collection
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