Request for Intervention, Longshore and Harbor Workers' Compensation Act

Request for Intervention, Longshore and Harbor Workers' Compensation Act

OMB: 1240-0058

IC ID: 237986

Information Collection (IC) Details

View Information Collection (IC)

Request for Intervention, Longshore and Harbor Workers' Compensation Act
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 702.301 20 CFR 702.311 20 CFR 702.315 20 CFR 702.134 20 CFR 702.312 20 CFR 702.142 20 CFR 702.102 20 CFR 702.321 20 CFR 702.242

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction LS-4 Attorney Fee Approval Request LS-4 Attorney Fee Approval Request.pdf Yes Yes Fillable Fileable
Form and Instruction LS-5 Aplication for Special Fund Relief LS-5 Application for Special Fund Relief.pdf Yes Yes Fillable Fileable
Form and Instruction LS-7 Request for Intervention LS-7 Intervention Request.pdf Yes Yes Fillable Fileable
Form and Instruction LS-8 Settlement Approval Request Section 8(i) LS-8 Settlement Approval Request 8(i).pdf Yes Yes Fillable Fileable
Form and Instruction LS-9 Stipulation Approval Request LS-9 Stipulation Approval Request.pdf Yes Yes Fillable Fileable
Form and Instruction LS-6 LS-6 Commutation Application LS-6 Commutation Application.pdf Yes Yes Fillable Fileable

Income Security General Retirement and Disability

DOL/OWCP-3, DOL/OWCP-4  81 FR 25765

12,414 0
   
Individuals or Households
 
   70 %

  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 12,414 0 0 0 0 12,414
Annual IC Time Burden (Hours) 3,189 0 -2 0 0 3,191
Annual IC Cost Burden (Dollars) 343 0 343 0 0 0

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

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