Information Collection

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

IC 214968 under ICR 202111-1240-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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-801 Request for Electronic Service of Orders – Waiver of Certified Mail Requirement Form and Instruction
LS-801 Waiver of Service by Registered or Certified Mail for Em ls-801.pdf www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-801.pdf Form and Instruction
LS-801 Waiver of Service by Registered or Certified Mail for Em ls-801.pdf www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-801.pdf Form and Instruction
LS-802 Waiver of Service by Registered or Certified Mail for Cl ls-802.pdf www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-802.pdf Form and Instruction
LS-802 Waiver of Service by Registered or Certified Mail for Cl ls-802.pdf www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-802.pdf Form and Instruction

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 and Instruction	LS-801	Waiver of Service by Registered or Certified Mail for Employers and/or Insurance Carriers	ls-801.pdf	https://www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-801.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	LS-802	Waiver of Service by Registered or Certified Mail for Claimants and Authorized Representatives	ls-802.pdf	https://www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-802.pdf	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: DOL/OWCP-3	FR Citation: 81 FR 25765

Number of Respondents: 9,240	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	9,240	-4,760	14,000
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.