Information Collection Request
Request for Intervention, Longshore and Harbor Workers' Compensation Act
ICR 202210-1240-001 · OMB 1240-0058 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1240-0058 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form LS-4 Request for Intervention, Longshore and Harbor Workers' Compensation Act |
Form and Instruction | Modified | Repair queued |
 1240-0058 Supporting Statement_1-26-23_CLEAN.docx |
Supporting Statement A | Uploaded 2023-01-26 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 237986 |  Request for Intervention, Longshore and Harbor Workers' Compensation Act |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DOL/OWCP |
| OMB Control No | 1240-0058 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202012-1240-004 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |