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DOL Home > Find It! By Form > DOL Form |
DOL Form LS-210
Agency: | 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: | 1240-0003 |