Form LS-206 is used by insurance
carriers and self-insurers to report the initial payment of
compensation benefits to injured claimants as required by the
Longshore and Harbor Workers' Compensation Act.
US Code:
33 USC 914(b) and (c) Name of Law: Longshore and Harbor
Workers' Compensation Act
Cosmetic changes to Form LS-206
technically make this submission a revision; however, those changes
are not expected to alter the public burden. The burden hours have
been reduced from 5,250 hours to 4,200 hours which is a reduction
of -1050 hours due to reduced reporting under the Act. The
operation and maintenance costs have been reduced by -$2,283.00
(from $10,935 to $8,652.00) due to a decrease in the number or
responses received since the last clearance.
$46,072
No
No
No
No
No
Uncollected
Cheryl Jordan 202 693-0289
jordan.cheryl@dol.gov
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.