View ESA-OWCP-DLHWC's Form 1215-0031 Online
Agency: |
ESA-OWCP-DLHWC |
Title: |
DLHWC (Longshore) LS-210, Employer's Supplementary Report of Accident or Occupational Illness |
Form Description: |
DLHWC (Longshore) LS-210, Employer's Supplementary Report of Accident or Occupational Illness: The employer uses this form to notify the Department of Labor of changes to the initial injury report (LS-202) filed. |
OMB Control Number: |
1215-0031 |
OMB Expiration Date: |
Friday, December 31, 2010
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