Information Collection

Notice of Payments

IC 13642 under ICR 202406-1240-002 · OMB 1240-0041.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form LS-208 Notice of Payments	Form
LS-208 Notice of Payments LS-208 2024.pdf www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-208.pdf	Form
LS-208 Notice of Payments LS-208 2024.pdf www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-208.pdf	Form
DLHWC Seaportal.pdf DLHWC SEA Portal	IC Document
DLHWC Seaportal.pdf DLHWC SEA Portal	IC Document

IC Title:

Notice of Payments

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 702.235 20 CFR 702.234

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	LS-208	Notice of Payments	LS-208 2024.pdf	https://www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-208.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: 89 FR 19363

Number of Respondents: 550

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 94 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	32,016	-984	33,000
Annual IC Time Burden (Hours)	5,336	-164	5,500
Annual IC Cost Burden (Dollars)	1,440	-2,190	3,630

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
DLHWC SEA Portal	DLHWC Seaportal.pdf	09/24/2014

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