OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Notice of Payments

OMB 1240-0041 ยท DOL/OWCP.

OMB 1240-0041

Form LS-208, Notice of Payments, is used by insurance carriers and self-insured employers to report the payment of benefits under the Longshore and Harbors Workers Compensation Act.

The latest form for Notice of Payments expires 2027-08-31 and is listed under ICR 202406-1240-002.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form LS-208 Notice of PaymentsForm
LS208SupportingStatement2024_MN3_CLEAN.docxSupporting Statement A
914(c).docx Supplementary Document
914(b).docx Supplementary Document
20CFR702_702_236 - Penalty for failure to report termination of payments.htm Supplementary Document
20CFR702_702_235 - Report by employer of final payment of compensation.htm Supplementary Document
33 USC 914(g).doc Supplementary Document
Notice of Payments Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202406-1240-002 Revision of a currently approved collection 2024-07-24
202105-1240-001 Revision of a currently approved collection 2021-07-01 Approved with change
202008-1240-054 No material or nonsubstantive change to a currently approved collection 2020-12-15
201803-1240-001 Extension without change of a currently approved collection 2018-06-01 Approved without change
201712-1240-001 No material or nonsubstantive change to a currently approved collection 2018-01-09 Approved with change
201611-1240-003 No material or nonsubstantive change to a currently approved collection 2016-11-25 Approved without change
201411-1240-003 Revision of a currently approved collection 2015-02-27 Approved without change
201409-1240-009 No material or nonsubstantive change to a currently approved collection 2014-09-30 Approved without change
201110-1240-002 Revision of a currently approved collection 2012-01-13 Approved without change
201003-1240-041 Extension without change of a currently approved collection 2010-03-12 Approved without change