OMB
.report
Search
LS-210 Employer's Supplementary Report of Accident or Occupatio
Employer's First Report of Injury or Occupational Disease; Employer's Supplementary Report of Accident or Occupational Illness
ls-210 (002)
OMB: 1240-0003
OMB.report
DOL/OWCP
OMB 1240-0003
ICR 202312-1240-001
IC 13653
LS-210 Employer's Supplementary Report of Accident or Occupatio
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1240-0003 can be found here:
2024-03-19 - No material or nonsubstantive change to a currently approved collection
Document [pdf]
Download:
pdf
|
pdf
© 2024 OMB.report |
Privacy Policy