Information Collection

Pre-Hearing Statement

IC 13760 under ICR 202311-1240-002 · OMB 1240-0036.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form LS-18 Pre-Hearing Statement	Form and Instruction
LS-18 Pre-Hearing Statement ls-18 Rev Nov 2023 Final.pdf www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-18.pdf	Form and Instruction
LS-18 Pre-Hearing Statement ls-18 Rev Nov 2023 Final.pdf www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-18.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 702.317

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	LS-18	Pre-Hearing Statement	ls-18 Rev Nov 2023 Final.pdf	https://www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-18.pdf	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title: DOL/OWCP-3

FR Citation: 88 FR 60712

Number of Respondents: 8,422

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	8,422	4,622	3,800
Annual IC Time Burden (Hours)	1,432	786	646
Annual IC Cost Burden (Dollars)	0	-1,102	1,102

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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