Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Employer's First Report of Injury or Occupational Disease; Physician's Report on Impairment of Vision; and Employer's Supplementary Report of Accident or Occupational Illness Modified 24631 6158 11143 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: 24631 6158 11143  
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