OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Longshore and Harbor Workers' Compensation Act Pre-Hearing Statement

ICR 201506-1240-010 · OMB 1240-0036 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form LS-18 Pre-Hearing Statement Form Modified Available
Notice to OMB Reviewer - Non Material Change for Direct Final Rule (1240-0036).docx Justification for No Material/Nonsubstantive Change Uploaded 2014-12-18 Available
Justification for non-material change.docx Justification for No Material/Nonsubstantive Change Uploaded 2014-09-30 Available
20 CFR 702 317.pdf Supplementary Document Uploaded 2014-03-04 Repair queued
DOL GOVT-15.pdf Supplementary Document Uploaded 2014-03-04 Repair queued
OMB - Supporting Statement for 1240-0036 (LS-18).doc Supporting Statement A Uploaded 2014-06-19 Available
IC Document Collections
IC IDCollectionTypeStatusForm
13760 Pre-Hearing Statement Form Modified
ICR Details
1240-0036 201506-1240-010
Historical Active 201409-1240-006
DOL/OWCP
Longshore and Harbor Workers' Compensation Act Pre-Hearing Statement
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 06/05/2015
Retrieve Notice of Action (NOA) 06/05/2015
  Inventory as of this Action Requested Previously Approved
08/31/2017 08/31/2017 08/31/2017
3,100 0 3,100
527 0 527
1,402 0 1,612
Form LS-18 is used to refer cases to the Office of Administrative Law Judges for formal hearing under the Longshore and Harbor Workers' Compensation Act.
US Code: 33 USC 901 Name of Law: Longshore and Harbor Workers' Compensation Act
  
None
Final or interim final rulemaking 80 FR 12917 03/12/2015
  79 FR 12226 03/04/2014
79 FR 36098 06/25/2014
No
1
IC Title Form No. Form Name
Pre-Hearing Statement LS-18 Pre-Hearing Statement
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,100 3,100 0 0 0 0
Annual Time Burden (Hours) 527 527 0 0 0 0
Annual Cost Burden (Dollars) 1,402 1,612 0 -210 0 0
No
No
There is a decrease of 357 burden hours since the last clearance submission due to a decrease in reporting under the Act. There has been a change in the operation and maintenance cost from $2,444 to $1,512 (-832) due to a decrease in reporting under the Act.
$9,685
No
No
No
No
No
Uncollected
Cheryl Jordan 202 693-0289 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/12/2015