Payment of Compensation Without Award

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1240-0043 can be found here:

Documents and Forms

Document Name Document Type
Form LS-206 Payment of Compensation Without Award Form
LS-206 Payment of Compensation without Award ls-206.pdf www.dol.gov/esa/owcp/dlhwc/ls-206.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Payment of Compensation Without Award	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 702.234

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	LS-206	Payment of Compensation without Award	ls-206.pdf	http://www.dol.gov/esa/owcp/dlhwc/ls-206.pdf	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title: DOL/ESA-15	FR Citation: 58 FR 49599

Number of Respondents: 600	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 1 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	21,000	-3,500	24,500
Annual IC Time Burden (Hours)	5,250	-875	6,125
Annual IC Cost Burden (Dollars)	10,395	-605	11,000

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.