skip navigational links United States Department of Labor
May 8, 2009   
DOL Home > Find It! By Form > DOL Form
DOL Home

DOL Form LS-200

View ESA-OWCP-DLHWC's Form LS-200 Online htm
Agency: ESA-OWCP-DLHWC
Title: DLHWC (Longshore) LS-200, Report of Earnings
Form Description: DLHWC (Longshore) LS-200, Report of Earnings: This form is required and must be submitted by an employee who is being paid compensation by the Special Fund. The form reports all earnings from employment by the employee during the prior year or other specified period.
OMB Control Number: 1215-0160

 

Phone Numbers