Information Collection

Pre-Hearing Statement

IC 13760 under ICR 202311-1240-002 · OMB 1240-0036.

Documents and Forms

Document Name Document Type
Form LS-18 Pre-Hearing Statement Form and Instruction
LS-18 Pre-Hearing Statement ls-18 Rev Nov 2023 Final.pdf www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-18.pdf Form and Instruction
LS-18 Pre-Hearing Statement ls-18 Rev Nov 2023 Final.pdf www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-18.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Pre-Hearing Statement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 702.317

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	LS-18	Pre-Hearing Statement	ls-18 Rev Nov 2023 Final.pdf	https://www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-18.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: 88 FR 60712

Number of Respondents: 8,422	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	8,422	4,622	3,800
Annual IC Time Burden (Hours)	1,432	786	646
Annual IC Cost Burden (Dollars)	0	-1,102	1,102

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.