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

Forms and Documents

Document Name	Status
Form LS-801 Request for Electronic Service of Orders – Waiver of Certified Mail Requirement Form and Instruction	Modified
1240-0053 Supporting Statement (LS801-802) 2025_CLEAN.docx Supporting Statement A	2025-06-04
Privacy Act Systems DOL-OWCP-3.pdf Supplementary Document	2019-02-04

IC Document Collections

IC ID	Document Title	Status
214968	Request for Electronic Service of Orders – Waiver of Certified Mail Requirement Form and Instruction	Modified

ICR Details

OMB Control No: 1240-0053	ICR Reference No: 202502-1240-002
Status: Received in OIRA	Previous ICR Reference No: 202111-1240-001
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Request for Electronic Service of Orders - Waiver of Certified Mail Requirement
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 06/10/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	06/30/2025
Responses	58,732	9,240
Time Burden (Hours)	4,894	770
Cost Burden (Dollars)	330	0

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Abstract: The collections of information in the LS-801 and LS-802 forms waive the requirement for compensation orders to be delivered by certified mail.

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Authorizing Statute(s): US Code: 33 USC 919(e) Name of Law: Longshore and Harbor Workers' Compensation Act
   US Code: 33 USC 939(a)(1) Name of Law: Longshore and Harbor Workers' Compensation Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 11555	03/07/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 24415	06/10/2025
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Request for Electronic Service of Orders – Waiver of Certified Mail Requirement	LS-801, LS-802	Waiver of Service by Registered or Certified Mail for Employers and/or Insurance Carriers ,   Waiver of Service by Registered or Certified Mail for Claimants and Authorized Representatives

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	58,732	9,240	0	49,492	0	0
Annual Time Burden (Hours)	4,894	770	0	4,124	0	0
Annual Cost Burden (Dollars)	330	0	0	330	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The increase in the number of respondents and costs was a change in the method of estimating respondents from the previous submission which was based on a percentage of an estimate of total orders. This collection uses the actual number of LS-801 and LS-802 forms received in the prior fiscal year (Fiscal Year 2024) and categorized as LS-801 and LS-802. It is a more accurate estimate. Previous costs to respondents were 0 and are now $330 due to an error in the last request to OMB. Costs were $330 in the last supporting statement as well. There are no other changes to the ICR.

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Annual Cost to Federal Government: $99,057

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 06/10/2025

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