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Request for Examination and/or Treatment
OMB 1215-0066
OMB.report
DOL/ESA
OMB 1215-0066
OMB 1215-0066
Latest Forms, Documents, and Supporting Material
Document
Name
Form LS-1 Request for Examination and/or Treatment
Form
OMB - Supporting Statement for 1215-0066 (LS-1) December 2007.doc
Supporting Statement A
33 USC, Chapter 18 Section 907.doc
Supplementary Document
DOL-ESA-15.pdf
Supplementary Document
20CFR702.419.pdf
Supplementary Document
Request for Examination and/or Treatment
Form
All Historical Document Collections
200801-1215-001
Approved without change
Extension without change of a currently approved collection
2008-04-25
200505-1215-002
Approved without change
Extension without change of a currently approved collection
2005-05-27
200209-1215-003
Approved without change
Extension without change of a currently approved collection
2002-09-19
199909-1215-001
Approved without change
Extension without change of a currently approved collection
1999-09-23
199610-1215-001
Approved without change
Extension without change of a currently approved collection
1996-10-16
199309-1215-004
Approved without change
Extension without change of a currently approved collection
1993-09-22
199010-1215-001
Approved without change
Extension without change of a currently approved collection
1990-10-11
198910-1215-001
Approved without change
Extension without change of a currently approved collection
1989-10-11
198904-1215-017
Approved with change
No material or nonsubstantive change to a currently approved collection
1989-04-18
198610-1215-007
Approved without change
Revision of a currently approved collection
1986-10-10
198311-1215-001
Approved without change
Revision of a currently approved collection
1983-11-04
198309-1215-029
Approved with change
No material or nonsubstantive change to a currently approved collection
1983-09-06
197811-1215-004
Approved without change
Extension without change of a currently approved collection
1978-11-29
197312-1215-002
Approved with change
No material or nonsubstantive change to a currently approved collection
1973-12-06
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