Information Collection

Request for Electronic Service of Orders – Waiver of Certified Mail Requirement

IC 214968 under ICR 202008-1240-057 · OMB 1240-0053.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1240-0053 can be found here:

Documents and Forms

Document Name Document Type
Form LS-802 Request for Electronic Service of Orders – Waiver of Certified Mail Requirement Form
LS-801 Waiver of Service by Registered or Certified Mail for Em ls-801.pdf www.dol.gov/owcp/dlhwc/LS-801.pdf Form
LS-801 Waiver of Service by Registered or Certified Mail for Em ls-801.pdf www.dol.gov/owcp/dlhwc/LS-801.pdf Form
LS-802 Waiver of Service by Registered or Certified Mail for Cl ls-802.pdf www.dol.gov/owcp/dlhwc/LS-802.pdf. Form
LS-802 Waiver of Service by Registered or Certified Mail for Cl ls-802.pdf www.dol.gov/owcp/dlhwc/LS-802.pdf. Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Electronic Service of Orders â Waiver of Certified Mail Requirement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 702.349

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	LS-801	Waiver of Service by Registered or Certified Mail for Employers and/or Insurance Carriers	ls-801.pdf	http://www.dol.gov/owcp/dlhwc/LS-801.pdf	Yes	Yes	Fillable Fileable Signable
Form	LS-802	Waiver of Service by Registered or Certified Mail for Claimants and Authorized Representatives	ls-802.pdf	http://www.dol.gov/owcp/dlhwc/LS-802.pdf.	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: DOL/OWCP-3	FR Citation: 81 FR 25859

Number of Respondents: 14,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 66 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	14,000	4,760	9,240
Annual IC Time Burden (Hours)	770	0	770
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.