OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Notice of Termination, Suspension, Reduction, or Increase in Benefit Payments

OMB 1240-0030 · DOL/OWCP.

OMB 1240-0030

Coal mine operators who pay monthly benefits must notify the Department's Division of Coal Mine Workers' Compensation (DCMWC) of any change in payments and the reason for that change. DCMWC uses this notification to monitor payments and ensure that beneficiaries receive the correct benefit rate.

The latest form for Notice of Termination, Suspension, Reduction, or Increase in Benefit Payments expires 2028-11-30 and is listed under ICR 202505-1240-003.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form CM-908 Notice of Termination, Suspension, or Increase in Benefit PaymentForm
Form CM-908 Notice of Termination, Suspension, Reduction, or Increase in Benefit PaymentsForm
Supporting Statement 1240-0030 CM-908 2025 -OCIO1.docxSupporting Statement A
Supporting Statement 1240-0030 CM-908 2025 -OCIO1.docxSupporting Statement A
Justification 908.docxJustification for No Material/Nonsubstantive Change
Justification 908.docx Justification for No Material/Nonsubstantive Change
System of Record Notice-DOL OWCP-2.pdfSupplementary Document
System of Record Notice-DOL OWCP-2.pdf Supplementary Document
20 CFR 725.621.pdfSupplementary Document
20 CFR 725.621.pdf Supplementary Document
Notice of Termination, Suspension, Reduction, or Increase in Benefit Payments Form
Notice of Termination, Suspension, Reduction, or Increase in Benefit Payments Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202505-1240-003 Extension without change of a currently approved collection 2025-09-12
202401-1240-002 No material or nonsubstantive change to a currently approved collection 2024-01-31 Approved without change
202205-1240-002 Revision of a currently approved collection 2022-10-21 Approved without change
202110-1240-002 Revision of a currently approved collection 2021-12-23 Approved without change
202008-1240-043 No material or nonsubstantive change to a currently approved collection 2020-10-20 Approved without change
202002-1240-011 No material or nonsubstantive change to a currently approved collection 2020-02-21 Approved without change
201807-1240-002 Revision of a currently approved collection 2018-08-31 Approved without change
201502-1240-002 Revision of a currently approved collection 2015-06-03 Approved without change
201205-1240-001 Revision of a currently approved collection 2012-06-19 Approved without change
201003-1240-030 Extension without change of a currently approved collection 2010-03-12 Approved without change