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DOL Home > Find It! By Form > DOL Form |
DOL Form LS-570
Agency: | OWCP |
Title: | Carrier's Report of Issuance of Policy |
Form Description: | Form LS-570 is used by authorized carriers to report the policy of insurance issued for each insured employer. This form is to be sent to the deputy Commissioner in the compensation district indicated by the employer's address. |
OMB Control Number: | 1240-0004 |