Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Employer's First Report of Injury or Occupational Disease; Employer's Supplementary Report of Accident or Occupational Illness Modified 43039 10760 611 Form LS-210 Employer's Supplementary Report of Accident or Occupational Illness
Form and Instruction LS-202 Employer's First Report of Injury or Occupational Illness
Total burden requested under this ICR: 43039 10760 611  
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