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OMB Control No: 1240-0005	ICR Reference No: 202607-1240-001
Status: Received in OIRA	Previous ICR Reference No: 202304-1240-005
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Securing Financial Obligations Under the Longshore and Harbor Workers' Compensation Act and its Extensions
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: 08/19/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	08/31/2026
Responses	728	705
Time Burden (Hours)	911	881
Cost Burden (Dollars)	728	409

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	728	705	23
Annual Time Burden (Hours)	911	881	30
Annual Cost Burden (Dollars)	728	409	319

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: There is an increase of number of hours from the previously-established burden hours due to a slight increase in the number of authorized insurance carriers from the last submission. Burden hours have increased from 881 to 911 due to an increase in responses and respondents which increased both from 705 to 728.

Annual Cost to Federal Government: $23,680

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. No

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. No

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

Agency Contact: Michelle Massenberg 202 354-9624 massenberg.michelle@dol.gov

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