OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Request for Intervention, Longshore and Harbor Workers' Compensation Act

OMB 1240-0058 · DOL/OWCP.

OMB 1240-0058

The Office of Workers' Compensation Programs administers the Longshore and Harbor Workers' Compensation Act which, through these collections, provides benefits to workers injured in maritime employment on the navigable waters of the United States or in an adjoining area customarily used by an employer in loading, unloading, repairing, or building a vessel.

The latest form for Request for Intervention, Longshore and Harbor Workers' Compensation Act expires 2029-04-30 and is listed under ICR 202511-1240-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form LS-9 Stipulation Approval RequestForm and Instruction
Form LS-8 Settlement Approval Request Section 8(i)Form and Instruction
Form LS-7 Request for InterventionForm and Instruction
Form LS-6 Commutation ApplicationForm and Instruction
Form LS-5 Application for Special FundForm and Instruction
Form LS-4 Attorney Fee Order RequestForm and Instruction
1240-0058 Request for Intervention LHWCA_Supporting Statement_OCIO1-ao jp jm_final.docxSupporting Statement A
PC2.pdfPublic Comments
PC1.pdfPublic Comments
Request for Intervention, Longshore and Harbor Workers' Compensation Act Form and Instruction
Request for Intervention, Longshore and Harbor Workers' Compensation Act Form and Instruction
Request for Intervention, Longshore and Harbor Workers' Compensation Act Form and Instruction
Request for Intervention, Longshore and Harbor Workers' Compensation Act Form and Instruction
Request for Intervention, Longshore and Harbor Workers' Compensation Act Form and Instruction
Request for Intervention, Longshore and Harbor Workers' Compensation Act Form and Instruction
Request for Intervention, Longshore and Harbor Workers' Compensation Act Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202511-1240-001 Extension without change of a currently approved collection 2026-03-06 Approved without change
202210-1240-001 Extension without change of a currently approved collection 2023-02-02 Approved without change
202012-1240-004 No material or nonsubstantive change to a currently approved collection 2020-12-15
201910-1240-001 New collection (Request for a new OMB Control Number) 2019-11-25 Approved without change