OMB control number
Report Of Injury Experience Of Self-insured Employer
OMB 1215-0033 ยท DOL/ESA.
OMB 1215-0033
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 REPORT OF INJURY EXPERIENCE OF SELF-INSURED EMPLOYER |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 198308-1215-001 | Revision of a currently approved collection | 1983-08-09 | Approved without change | |
| 198206-1215-014 | No material or nonsubstantive change to a currently approved collection | 1982-06-30 | Approved with change | |
| 197807-1215-003 | Extension without change of a currently approved collection | 1978-07-21 | Approved without change |