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Warning
These are the most frequently requested U.S. Department of Labor forms. You can complete some forms online, while you can download and print all others.
- 5500 Series (Form Number - 5500; Agency - Employee Benefits Security Administration)
- Administrative Subpoena to Appear & Testify at a Deposition (Form Number - N/A; Agency - Office of Administrative Law Judges)
- Administrative Subpoena to Appear & Testify at a Hearing (Form Number - N/A; Agency - Office of Administrative Law Judges)
- Administrative Subpoena to Produce Documents, Information or Objects, or to Permit Inspection of Premises (Form Number - N/A; Agency - Office of Administrative Law Judges)
- Agreement and Activities Report (Form Number - LM-20; Agency - Office of Labor-Management Standards)
- Agreement and Undertaking (Self-Insured Employer) (Form Number - OWCP-01; Agency - Office of Workers' Compensation Programs)
- Agreement and Undertaking (Insurance Carrier) (Form Number - LS-275ic; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Agreement and Undertaking (Self-Insured Employer) (Form Number - LS-275si; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Agreement to Mediate (Form Number - N/A; Agency - Office of Administrative Law Judges)
- Agricultural and Food Processing Clearance Order (Form Number - 790; Agency - Employment and Training Administration)
- Appeal Form (Form Number - AB-1; Agency - Employees' Compensation Appeals Board)
- Application for Alien Employment Certification - Part A (Form Number - 750A; Agency - Employment and Training Administration)
- Application for Alien Employment Certification - Part B (Form Number - 750B; Agency - Employment and Training Administration)
- Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by The U.S. Department of Labor (Form Number - CM-972; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Application for Authority to Employ Full-Time Students at Subminimum Wages in Retail or Service Establishments or Agriculture Under Regulations 29 C.F.R. Part 519 (Form Number - WH-200; Agency - Wage and Hour Division)
- Application for Authority to Employ Six or Fewer Full-Time Students at Subminimum Wages in Retail or Service Establishments or Agriculture Under Regulations 29 C.F.R. Part 519 (Form Number - WH-202; Agency - Wage and Hour Division)
- Application for Authority to Employ Workers with Disabilities at Subminimum Wages (Form Number - WH-226 ; Agency - Wage and Hour Division)
- Application for Certificateto Employ Homeworkers (Form Number - WH-46; Agency - Wage and Hour Division)
- Application for Continuation of Death Benefit for Student (Form Number - LS-266; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Application for Permanent Employment Certification (Form Number - 9089; Agency - Employment and Training Administration)
- Application for Prevailing Wage Determination (Form Number - 9141; Agency - Employment and Training Administration)
- Application for Prevailing Wage Determination (Form Number - 9141C; Agency - Employment and Training Administration)
- Application for Security Deposit Determination. State Guarantee Fund Longshore Security Factor Chart (Form Number - LS-276; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Application for Self-Insurance instructions (Form Number - LS-271; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Application for Special Industrial Homeworker Certificate (Form Number - WH-2; Agency - Wage and Hour Division)
- Application For Special Relief Fund (Form Number - LS-5; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Application to Employ Student-Learners at Subminimum Wages (Form Number - WH-205; Agency - Wage and Hour Division)
- Application to write Longshore Insurance (Carriers) (Form Number - LS-272; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Approval of Compromise of Third Person Cause of Action (Form Number - LS-33; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Attending Physician's Report (Form Number - CA-20; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Attending Physician's Supplementary Report (Form Number - LS-204; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Attorney Fee Approval Request (Form Number - LS-4; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Authorization For Release Of Medical Information (Black Lung Benefits) (Form Number - CM-936; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Black Lung Benefits Act Evidence Summary Form (Form Number - N/A; Agency - Office of Administrative Law Judges)
- Carrier's Report of Issuance of Policy (formerly Card Report of Insurance) (Form Number - LS-570; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Certificate of Electrical/Noise Training (Form Number - 5000-1; Agency - Mine Safety and Health Administration)
- Certificate of Medical Necessity (Form Number - CM-893; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Certificate of Physical Qualification for Mine Rescue Work (Form Number - 5000-3; Agency - Mine Safety and Health Administration)
- Certificate of Training (Form Number - 5000-23; Agency - Mine Safety and Health Administration)
- Certificate of Training Form (Form Number - WH-5; Agency - Wage and Hour Division)
- Certificates of Achievement in Safety (Form Number - N/A; Agency - Mine Safety and Health Administration)
- Certification by School Official (Form Number - CM-981; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Certification of Funeral Expenses (Form Number - LS-265; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Claim for Compensation (Form Number - CA-7; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Claim for Compensation by Parents, Brothers, Sisiters, GrandParents, or GrandChildren (Form Number - CA-5b; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Claim for Compensation by Widow, Widower, and/or Children (Form Number - CA-5; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Claim For Continuance of Compensation Under the Federal Employees' Compensation Act (Form Number - CA-12; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Claim for Death Benefits (Form Number - LS-262; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Claim For Medical Reimbursement (Form Number - OWCP-915; Agency - Office of Workers' Compensation Programs)
- Claim for Reimbursement Assisted Reemployment (Form Number - CA-2231; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act (Form Number - CA-278; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Claim for Survivor Benefits Under the Federal Employees’ Compensation Act Section 8102a Death Gratuity (Form Number - CA-41; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Claimant's Statement (Form Number - LS-267; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Commutation Application (Form Number - LS-6; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Complaint/Apparent Violation Form (Form Number - 8429; Agency - Employment and Training Administration)
- Contractor ID Request (Form Number - 7000-52; Agency - Mine Safety and Health Administration)
- CW-1 Application for Temporary Employment Certification (Form Number - 9142C; Agency - Employment and Training Administration)
- DBRA Certified Payroll Form (Form Number - WH-347; Agency - Wage and Hour Division)
- DBRA Report of Construction Contractor’s Wage Rates (Form Number - WH-10; Agency - Wage and Hour Division)
- Description Of Coal Mine Work and Other Employment (Form Number - CM-913; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Designation of a Recipient of the Federal Employees' Compensation Act Death Gratuity Payment under 5 U.S.C. § 8102a (Form Number - CA-40; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Domestic Agricultural In- Season Wage Report (Form Number - 232; Agency - Employment and Training Administration)
- Domestic Agricultural In-season Wage Finding Process (Form Number - 385; Agency - Employment and Training Administration)
- Duty Status Report (Form Number - CA-17; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Electrically Operated Equipment Field Approval Application (Coal Only) (Form Number - 2000-38; Agency - Mine Safety and Health Administration)
- Electronic Training Plan Advisor (Form Number - N/A; Agency - Mine Safety and Health Administration)
- Employee's Claim (Form Number - EE-1; Agency - Office of Workers' Compensation Programs - Division of Energy Employees Occupational Illness Compensation)
- Employee's Claim for Compensation (Form Number - LS-203; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Employer Report (Form Number - LM-10; Agency - Office of Labor-Management Standards)
- Employer-Provided Survey Attestations to Accompany H-2B Prevailing Wage Determination Request Based on a Non-OES Survey (Form Number - 9165; Agency - Employment and Training Administration)
- Employer's First Report of Injury or Occupational Illness (Form Number - LS-202; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Employer's Supplementary Report of Accident or Occupational Illness (Form Number - LS-210; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Employers’ Attestation to Use Alien Crewmembers for Longshore Activities in the State of Alaska (Form Number - 9033-A; Agency - Employment and Training Administration)
- Employers’ Attestation to Use Alien Crewmembers for Longshore Activities in U.S. Ports Form ETA 9033 (Form Number - 9033; Agency - Employment and Training Administration)
- Employment History (Form Number - CM-911a; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Employment History (Form Number - EE-3; Agency - Office of Workers' Compensation Programs - Division of Energy Employees Occupational Illness Compensation)
- Employment History Affidavit (Form Number - EE-4; Agency - Office of Workers' Compensation Programs - Division of Energy Employees Occupational Illness Compensation)
- EPPA Notice to Examinee (Form Number - WH-1481; Agency - Wage and Hour Division)
- Evidence Required in Support of a Claim for Occupational Disease (Form Number - CA-35; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Federal Contractor Discrimination Complaint (Form Number - N/A; Agency - Office of Federal Contract Compliance Programs)
- Federal Contractor Reporting - Veteran Hiring (Form Number - VETS-4212; Agency - Veterans' Employment and Training Service)
- Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation (Form Number - CA-1; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- FMLA Certification for Serious Injury or Illness of a Veteran for Wage and Hour Division Military Caregiver Leave (Form Number - WH-385V; Agency - Wage and Hour Division)
- FMLA Certification for Serious Injury orIllness of Covered Servicemember -- for Military Family Leave (Form Number - WH-385; Agency - Wage and Hour Division)
FMLA Certification of Health Care Providerfor Employee’s Serious Health Condition (Form Number - WH-380-E; Agency - Wage and Hour Division)
This form can't be completed online. It can be downloaded and completed with Adobe's free Acrobat Reader. Use when a leave request is due to the medical condition of the employee.
FMLA Certification of Health Care Providerfor Family Member’s Serious Health Condition (Form Number - WH-380-F; Agency - Wage and Hour Division)
This form can't be completed online. It can be downloaded and completed with Adobe's free Acrobat Reader. Use when a leave request is due to the medical condition of the employee’s family member.
- FMLA Certification of Qualifying Exigency For Military Family Leave (Form Number - WH-384; Agency - Wage and Hour Division)
- FMLA Designation Notice (Form Number - WH-382 ; Agency - Wage and Hour Division)
- FMLA Notice of Eligibility and Rights & Responsibilities (Form Number - WH-381; Agency - Wage and Hour Division)
- Foreign Labor Certification Quarterly Activity Report (Form Number - 9127; Agency - Employment and Training Administration)
- H-1B Nonimmigrant Information (Form Number - WH-4; Agency - Wage and Hour Division)
- H-2A Application for Temporary Employment Certification (Form Number - 9142A; Agency - Employment and Training Administration)
- H-2B Application for Temporary Employment Certification (Form Number - 9142B; Agency - Employment and Training Administration)
- Hazardous Condition Complaint (Form Number - N/A; Agency - Mine Safety and Health Administration)
- Health Activity Certification or Hoisting Engineers Qualification Request (Form Number - 5000-41; Agency - Mine Safety and Health Administration)
- Health Insurance Claim Form (Form Number - OWCP-1500; Agency - Office of Workers' Compensation Programs)
- Higher Education to Employ its Full-time Students at Subminimum Wages Under Regulations 29 C.F.R. Part 519 (Form Number - WH-201; Agency - Wage and Hour Division)
- Homeworker Handbook (Form Number - WH-75; Agency - Wage and Hour Division)
- Homeworker Handbook (Spanish) (Form Number - WH-75; Agency - Wage and Hour Division)
- Inspector General Hotline (Form Number - N/A; Agency - Office of Inspector General)
- Instructions For Completion of Form CM-921 (Form Number - CM-921; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Labor Organization Annual Report (Form Number - LM-2; Agency - Office of Labor-Management Standards)
- Labor Organization Annual Report (Form Number - LM-3; Agency - Office of Labor-Management Standards)
- Labor Organization Annual Report (Form Number - LM-4; Agency - Office of Labor-Management Standards)
- Labor Organization Information Report (Form Number - LM-1; Agency - Office of Labor-Management Standards)
- Labor Organization Officer and Employee Report (Form Number - LM-30; Agency - Office of Labor-Management Standards)
- LCA Online Application (Form Number - 9035; Agency - Employment and Training Administration)
- Leave Buy Back (LBB) Worksheet/Certification and Election (Form Number - CA-7b; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Legal Identification Report (Form Number - 2000-7; Agency - Mine Safety and Health Administration)
- Letter to Dependants to Verify Claimant Support (Form Number - CA-1031; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Letter to Parents in Death Claim Development (Form Number - CA-1074; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LHWCA Prehearing Statement Form (Form Number - N/A; Agency - Office of Administrative Law Judges)
- LHWCA Uniform Stipulations Form (Form Number - N/A; Agency - Office of Administrative Law Judges)
- Manage/Update Diesel Inventory (Form Number - N/A; Agency - Mine Safety and Health Administration)
- Medical History and Examination for Coal Mine Workers' Pneumoconiosis (Form Number - CM-988; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Medical Requirements (Form Number - EE-7; Agency - Office of Workers' Compensation Programs - Division of Energy Employees Occupational Illness Compensation)
- Medical Travel Refund Request – Mileage (Form Number - OWCP-957A; Agency - Office of Workers' Compensation Programs)
- Medical Travel Refund Request – Expenses (Form Number - OWCP-957B; Agency - Office of Workers' Compensation Programs)
- Mine Accident, Injury and Illness Report (Form Number - 7000-1; Agency - Mine Safety and Health Administration)
- Mine ID Request (Form Number - 7000-51; Agency - Mine Safety and Health Administration)
- Miner's Claim For Benefits Under The Black Lung Benefits Act (Form Number - CM-911; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- MSPA Application for a Farm Labor Contractor or Farm Labor ContractorEmployee Certificate of Registration (Form Number - WH-530; Agency - Wage and Hour Division)
- MSPA Application for a Farm Labor Contractor or Farm Labor ContractorEmployee Certificate of Registration (Spanish) (Form Number - WH-530; Agency - Wage and Hour Division)
- MSPA Doctor’s Certificate (Form Number - WH-515; Agency - Wage and Hour Division)
- MSPA Housing Occupancy Certificate (Form Number - WH-520; Agency - Wage and Hour Division)
- MSPA Housing Terms and Conditions (Form Number - WH-521; Agency - Wage and Hour Division)
- MSPA Vehicle Mechanical Inspection Report for Transportation Subjectto Department of Transportation Requirements (Form Number - WH-514; Agency - Wage and Hour Division)
- MSPA Wage Statement (Form Number - WH-501; Agency - Wage and Hour Division)
- MSPA Wage Statement (Spanish) (Form Number - WH-501; Agency - Wage and Hour Division)
- MSPA Worker Information – Terms of Employment (Form Number - WH-516; Agency - Wage and Hour Division)
- MSPA Worker Information – Terms of Employment (Haitian Creole) (Form Number - WH-516; Agency - Wage and Hour Division)
- MSPA Worker Information – Terms of Employment (Spanish) (Form Number - WH-516; Agency - Wage and Hour Division)
- Multiple Employer Welfare Arrangements (MEWAs) Annual Report (Form Number - M-1; Agency - Employee Benefits Security Administration)
- Notice of Controversion of Right to Compensation (Form Number - LS-207; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Notice of Employee's Injury or Death (Form Number - LS-201; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Notice of Final Payment or Suspension of Compensation Payments (Form Number - LS-208; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Notice of Law Enforcement Officer's Death (Form Number - CA-722; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Notice of Law Enforcement Officer's Injury Or Occupational Disease (Form Number - CA-721; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Notice of Occupational Disease and Claim for Compensation (Form Number - CA-2; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Notice of Recurrence (Form Number - CA-2a; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Notice of Termination, Suspension, Reduction or Increase in Benefit Payments (Form Number - CM-908; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Official Notice of Employees’ Death for Purposes of FECA Section 8102a Death Gratuity (Form Number - CA-42; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Official Supervisor's Report of Employee's Death (Form Number - CA-6; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Operator Response to Notice of Claim (Form Number - CM-2970a; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Operator Response to Schedule for Submission of Additional Evidence (Form Number - CM-2970; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Operator’s Annual Certification of Mine Rescue Teams Qualifications (Form Number - 2000-224; Agency - Mine Safety and Health Administration)
- Order Appointing Mediator (Form Number - N/A; Agency - Office of Administrative Law Judges)
- Overpayment Recovery Questionnaire (Form Number - OWCP-20; Agency - Office of Workers' Compensation Programs)
- Physician's/Medical Officer's Statement (Form Number - CM-787; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Pre-Hearing Statement (Form Number - LS-18; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Provider Enrollment form (Form Number - OWCP-1168; Agency - Office of Workers' Compensation Programs)
- Quarterly Mine Employment and Coal Production Report (Form Number - 7000-2; Agency - Mine Safety and Health Administration)
- Receipts and Disbursements Report (Form Number - LM-21; Agency - Office of Labor-Management Standards)
- Record of Individual Exposure to Radon Daughters (Form Number - 4000-9; Agency - Mine Safety and Health Administration)
- Rehabilitation Action Report (Form Number - OWCP-44; Agency - Office of Workers' Compensation Programs)
- Rehabilitation Maintenance Certificate (Form Number - OWCP-17; Agency - Office of Workers' Compensation Programs)
- Rehabilitation Plan And Award (Form Number - OWCP-16; Agency - Office of Workers' Compensation Programs)
- Report Commencement/Closure of Operation – Metal and Nonmetal Mines (Form Number - N/A; Agency - Mine Safety and Health Administration)
- Report of Arterial Blood Gas Study (Form Number - CM-1159; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Report of Changes That May Affect Your Black Lung Benefits (Form Number - CM-929; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Report of Changes That May Affect Your Black Lung Benefits (Form Number - CM-929P; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Report of Earnings (Form Number - LS-200; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Report of Injury Experience of Insurance Carrier or Self-Insured Employer (Form Number - LS-274; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Report of Payments. (Form Number - LS-513; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Report of Ventilatory Study (Form Number - CM-2907; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Report on Selection of Delegates and Officers (Form Number - LM-15A; Agency - Office of Labor-Management Standards)
- Representative of Miners Designation Form (Form Number - 2000-238; Agency - Mine Safety and Health Administration)
- Representative Payee Report (Form Number - CM-623; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Representative Payee Report (Form Number - CM-623S; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Request an MSHA Individual Identification Number (MIIN) (Form Number - 5000-46; Agency - Mine Safety and Health Administration)
- Request for Appointment of Mediator (Form Number - N/A; Agency - Office of Administrative Law Judges)
- Request for Earnings Information (Form Number - LS-426; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Request for Examination and/or Treatment (Form Number - LS-1; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Request for Intervention (Form Number - LS-7; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Request To Be Selected As Payee (Form Number - CM-910; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Roentgenographic Interpretation (Form Number - CM-933; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Roentgenographic Quality Rereading (Form Number - CM-933b; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Safety and Health Complaint (Form Number - N/A; Agency - Occupational Safety and Health Administration)
- Self Contained Self Rescuer (SCSR) Inventory and Report (Form Number - 2000-222; Agency - Mine Safety and Health Administration)
- Settlement Approval Request Section 8(i) (Form Number - LS-8; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Settlement Judge Request (Form Number - N/A; Agency - Office of Administrative Law Judges)
- Statement of Recovery Letter with Long Form (Form Number - CA-1108; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Statement of Recovery Letter with Short Form (Form Number - CA-1122; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Stipulation Approval Request (Form Number - LS-9; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilities at Subminimum Wages (Form Number - WH-226A; Agency - Wage and Hour Division)
- Surety Company Annual Report (Form Number - S-1; Agency - Office of Labor-Management Standards)
- Survivor's Claim (Form Number - EE-2; Agency - Office of Workers' Compensation Programs - Division of Energy Employees Occupational Illness Compensation)
- Survivor's Form For Benefits Under The Black Lung Benefits Act (Form Number - CM-912; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- Terminal Trusteeship Report (Form Number - LM-16; Agency - Office of Labor-Management Standards)
- Time Analysis Form, used for claiming compensation, including repurchase of paid leave (Form Number - CA-7a; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Trusteeship Report (Form Number - LM-15; Agency - Office of Labor-Management Standards)
- Uniform Billing Form (Form Number - OWCP-04; Agency - Office of Workers' Compensation Programs)
- Wage Complaints (Form Number - N/A; Agency - Wage and Hour Division)
- Wage Survey Interview Record (Form Number - 232A; Agency - Employment and Training Administration)
- Waiver of Service by Registered or Certified Mail for Claimants and Authorized Representatives (Form Number - LS-802; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Waiver of Service by Registered or Certified Mail for Employers and/or Insurance Carriers (Form Number - LS-801; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- What A Federal Employee Should Do When Injured At Work (Form Number - CA-10; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- Work Capacity Evaluation Cardiovascular/Pulmonary Conditions (Form Number - OWCP-5b; Agency - Office of Workers' Compensation Programs)
- Work Capacity Evaluation for Musculoskeletal Conditions (Form Number - OWCP-5c; Agency - Office of Workers' Compensation Programs)
- Work Capacity Evaluation Psychiatric/Psychological Conditions (Form Number - OWCP-5a; Agency - Office of Workers' Compensation Programs)
- 232 (Form Name - Domestic Agricultural In- Season Wage Report; Agency - Employment and Training Administration)
- 232A (Form Name - Wage Survey Interview Record; Agency - Employment and Training Administration)
- 385 (Form Name - Domestic Agricultural In-season Wage Finding Process; Agency - Employment and Training Administration)
- 750A (Form Name - Application for Alien Employment Certification - Part A; Agency - Employment and Training Administration)
- 750B (Form Name - Application for Alien Employment Certification - Part B; Agency - Employment and Training Administration)
- 790 (Form Name - Agricultural and Food Processing Clearance Order; Agency - Employment and Training Administration)
- 2000-7 (Form Name - Legal Identification Report; Agency - Mine Safety and Health Administration)
- 2000-38 (Form Name - Electrically Operated Equipment Field Approval Application (Coal Only); Agency - Mine Safety and Health Administration)
- 2000-222 (Form Name - Self Contained Self Rescuer (SCSR) Inventory and Report; Agency - Mine Safety and Health Administration)
- 2000-224 (Form Name - Operator’s Annual Certification of Mine Rescue Teams Qualifications; Agency - Mine Safety and Health Administration)
- 2000-238 (Form Name - Representative of Miners Designation Form; Agency - Mine Safety and Health Administration)
- 4000-9 (Form Name - Record of Individual Exposure to Radon Daughters; Agency - Mine Safety and Health Administration)
- 5000-1 (Form Name - Certificate of Electrical/Noise Training; Agency - Mine Safety and Health Administration)
- 5000-3 (Form Name - Certificate of Physical Qualification for Mine Rescue Work; Agency - Mine Safety and Health Administration)
- 5000-23 (Form Name - Certificate of Training; Agency - Mine Safety and Health Administration)
- 5000-41 (Form Name - Health Activity Certification or Hoisting Engineers Qualification Request; Agency - Mine Safety and Health Administration)
- 5000-46 (Form Name - Request an MSHA Individual Identification Number (MIIN); Agency - Mine Safety and Health Administration)
- 5500 (Form Name - 5500 Series; Agency - Employee Benefits Security Administration)
- 7000-1 (Form Name - Mine Accident, Injury and Illness Report; Agency - Mine Safety and Health Administration)
- 7000-2 (Form Name - Quarterly Mine Employment and Coal Production Report; Agency - Mine Safety and Health Administration)
- 7000-51 (Form Name - Mine ID Request; Agency - Mine Safety and Health Administration)
- 7000-52 (Form Name - Contractor ID Request; Agency - Mine Safety and Health Administration)
- 8429 (Form Name - Complaint/Apparent Violation Form; Agency - Employment and Training Administration)
- 9033 (Form Name - Employers’ Attestation to Use Alien Crewmembers for Longshore Activities in U.S. Ports Form ETA 9033; Agency - Employment and Training Administration)
- 9033-A (Form Name - Employers’ Attestation to Use Alien Crewmembers for Longshore Activities in the State of Alaska; Agency - Employment and Training Administration)
- 9035 (Form Name - LCA Online Application; Agency - Employment and Training Administration)
- 9089 (Form Name - Application for Permanent Employment Certification; Agency - Employment and Training Administration)
- 9127 (Form Name - Foreign Labor Certification Quarterly Activity Report; Agency - Employment and Training Administration)
- 9141 (Form Name - Application for Prevailing Wage Determination; Agency - Employment and Training Administration)
- 9141C (Form Name - Application for Prevailing Wage Determination; Agency - Employment and Training Administration)
- 9142A (Form Name - H-2A Application for Temporary Employment Certification; Agency - Employment and Training Administration)
- 9142B (Form Name - H-2B Application for Temporary Employment Certification; Agency - Employment and Training Administration)
- 9142C (Form Name - CW-1 Application for Temporary Employment Certification; Agency - Employment and Training Administration)
- 9165 (Form Name - Employer-Provided Survey Attestations to Accompany H-2B Prevailing Wage Determination Request Based on a Non-OES Survey; Agency - Employment and Training Administration)
- AB-1 (Form Name - Appeal Form; Agency - Employees' Compensation Appeals Board)
- CA-1 (Form Name - Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-2 (Form Name - Notice of Occupational Disease and Claim for Compensation; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-2a (Form Name - Notice of Recurrence; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-5 (Form Name - Claim for Compensation by Widow, Widower, and/or Children; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-5b (Form Name - Claim for Compensation by Parents, Brothers, Sisiters, GrandParents, or GrandChildren; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-6 (Form Name - Official Supervisor's Report of Employee's Death; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-7 (Form Name - Claim for Compensation; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-7a (Form Name - Time Analysis Form, used for claiming compensation, including repurchase of paid leave; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-7b (Form Name - Leave Buy Back (LBB) Worksheet/Certification and Election; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-10 (Form Name - What A Federal Employee Should Do When Injured At Work; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-12 (Form Name - Claim For Continuance of Compensation Under the Federal Employees' Compensation Act; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-17 (Form Name - Duty Status Report; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-20 (Form Name - Attending Physician's Report; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-35 (Form Name - Evidence Required in Support of a Claim for Occupational Disease; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-40 (Form Name - Designation of a Recipient of the Federal Employees' Compensation Act Death Gratuity Payment under 5 U.S.C. § 8102a; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-41 (Form Name - Claim for Survivor Benefits Under the Federal Employees’ Compensation Act Section 8102a Death Gratuity; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-42 (Form Name - Official Notice of Employees’ Death for Purposes of FECA Section 8102a Death Gratuity; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-278 (Form Name - Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-721 (Form Name - Notice of Law Enforcement Officer's Injury Or Occupational Disease; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-722 (Form Name - Notice of Law Enforcement Officer's Death; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-1031 (Form Name - Letter to Dependants to Verify Claimant Support; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-1074 (Form Name - Letter to Parents in Death Claim Development; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-1108 (Form Name - Statement of Recovery Letter with Long Form; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-1122 (Form Name - Statement of Recovery Letter with Short Form; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CA-2231 (Form Name - Claim for Reimbursement Assisted Reemployment; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- CM-623 (Form Name - Representative Payee Report; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-787 (Form Name - Physician's/Medical Officer's Statement; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-893 (Form Name - Certificate of Medical Necessity; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-908 (Form Name - Notice of Termination, Suspension, Reduction or Increase in Benefit Payments; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-910 (Form Name - Request To Be Selected As Payee; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-911 (Form Name - Miner's Claim For Benefits Under The Black Lung Benefits Act; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-911a (Form Name - Employment History; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-912 (Form Name - Survivor's Form For Benefits Under The Black Lung Benefits Act; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-913 (Form Name - Description Of Coal Mine Work and Other Employment; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-921 (Form Name - Instructions For Completion of Form CM-921; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-929 (Form Name - Report of Changes That May Affect Your Black Lung Benefits; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-929P (Form Name - Report of Changes That May Affect Your Black Lung Benefits; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-933 (Form Name - Roentgenographic Interpretation; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-933b (Form Name - Roentgenographic Quality Rereading; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-936 (Form Name - Authorization For Release Of Medical Information (Black Lung Benefits); Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-972 (Form Name - Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by The U.S. Department of Labor; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-981 (Form Name - Certification by School Official; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-988 (Form Name - Medical History and Examination for Coal Mine Workers' Pneumoconiosis; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-1159 (Form Name - Report of Arterial Blood Gas Study; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-2907 (Form Name - Report of Ventilatory Study; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-2970 (Form Name - Operator Response to Schedule for Submission of Additional Evidence; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-2970a (Form Name - Operator Response to Notice of Claim; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- CM-623S (Form Name - Representative Payee Report; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation)
- EE-1 (Form Name - Employee's Claim; Agency - Office of Workers' Compensation Programs - Division of Energy Employees Occupational Illness Compensation)
- EE-2 (Form Name - Survivor's Claim; Agency - Office of Workers' Compensation Programs - Division of Energy Employees Occupational Illness Compensation)
- EE-3 (Form Name - Employment History; Agency - Office of Workers' Compensation Programs - Division of Energy Employees Occupational Illness Compensation)
- EE-4 (Form Name - Employment History Affidavit; Agency - Office of Workers' Compensation Programs - Division of Energy Employees Occupational Illness Compensation)
- EE-7 (Form Name - Medical Requirements; Agency - Office of Workers' Compensation Programs - Division of Energy Employees Occupational Illness Compensation)
- LM-1 (Form Name - Labor Organization Information Report; Agency - Office of Labor-Management Standards)
- LM-2 (Form Name - Labor Organization Annual Report; Agency - Office of Labor-Management Standards)
- LM-3 (Form Name - Labor Organization Annual Report ; Agency - Office of Labor-Management Standards)
- LM-4 (Form Name - Labor Organization Annual Report ; Agency - Office of Labor-Management Standards)
- LM-10 (Form Name - Employer Report; Agency - Office of Labor-Management Standards)
- LM-15 (Form Name - Trusteeship Report; Agency - Office of Labor-Management Standards)
- LM-15A (Form Name - Report on Selection of Delegates and Officers; Agency - Office of Labor-Management Standards)
- LM-16 (Form Name - Terminal Trusteeship Report; Agency - Office of Labor-Management Standards)
- LM-20 (Form Name - Agreement and Activities Report; Agency - Office of Labor-Management Standards)
- LM-21 (Form Name - Receipts and Disbursements Report; Agency - Office of Labor-Management Standards)
- LM-30 (Form Name - Labor Organization Officer and Employee Report; Agency - Office of Labor-Management Standards)
- LS-1 (Form Name - Request for Examination and/or Treatment; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-4 (Form Name - Attorney Fee Approval Request; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-5 (Form Name - Application For Special Relief Fund; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-6 (Form Name - Commutation Application; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-7 (Form Name - Request for Intervention; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-8 (Form Name - Settlement Approval Request Section 8(i); Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-9 (Form Name - Stipulation Approval Request; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-18 (Form Name - Pre-Hearing Statement; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-33 (Form Name - Approval of Compromise of Third Person Cause of Action; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-200 (Form Name - Report of Earnings; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-201 (Form Name - Notice of Employee's Injury or Death; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-202 (Form Name - Employer's First Report of Injury or Occupational Illness; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-203 (Form Name - Employee's Claim for Compensation; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-204 (Form Name - Attending Physician's Supplementary Report; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-207 (Form Name - Notice of Controversion of Right to Compensation; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-208 (Form Name - Notice of Final Payment or Suspension of Compensation Payments; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-210 (Form Name - Employer's Supplementary Report of Accident or Occupational Illness; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-262 (Form Name - Claim for Death Benefits; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-265 (Form Name - Certification of Funeral Expenses; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-266 (Form Name - Application for Continuation of Death Benefit for Student; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-267 (Form Name - Claimant's Statement; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-271 (Form Name - Application for Self-Insurance instructions; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-272 (Form Name - Application to write Longshore Insurance (Carriers); Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-274 (Form Name - Report of Injury Experience of Insurance Carrier or Self-Insured Employer; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-275ic (Form Name - Agreement and Undertaking (Insurance Carrier); Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-275si (Form Name - Agreement and Undertaking (Self-Insured Employer); Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-276 (Form Name - Application for Security Deposit Determination. State Guarantee Fund Longshore Security Factor Chart; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-426 (Form Name - Request for Earnings Information; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-513 (Form Name - Report of Payments.; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-570 (Form Name - Carrier's Report of Issuance of Policy (formerly Card Report of Insurance); Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-801 (Form Name - Waiver of Service by Registered or Certified Mail for Employers and/or Insurance Carriers; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- LS-802 (Form Name - Waiver of Service by Registered or Certified Mail for Claimants and Authorized Representatives; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)
- M-1 (Form Name - Multiple Employer Welfare Arrangements (MEWAs) Annual Report; Agency - Employee Benefits Security Administration)
- N/A (Form Name - Administrative Subpoena to Appear & Testify at a Deposition; Agency - Office of Administrative Law Judges)
- N/A (Form Name - Administrative Subpoena to Appear & Testify at a Hearing; Agency - Office of Administrative Law Judges)
- N/A (Form Name - Administrative Subpoena to Produce Documents, Information or Objects, or to Permit Inspection of Premises; Agency - Office of Administrative Law Judges)
- N/A (Form Name - Agreement to Mediate; Agency - Office of Administrative Law Judges)
- N/A (Form Name - Black Lung Benefits Act Evidence Summary Form; Agency - Office of Administrative Law Judges)
- N/A (Form Name - Certificates of Achievement in Safety; Agency - Mine Safety and Health Administration)
- N/A (Form Name - Electronic Training Plan Advisor; Agency - Mine Safety and Health Administration)
- N/A (Form Name - Federal Contractor Discrimination Complaint; Agency - Office of Federal Contract Compliance Programs)
- N/A (Form Name - Hazardous Condition Complaint; Agency - Mine Safety and Health Administration)
- N/A (Form Name - Inspector General Hotline; Agency - Office of Inspector General)
- N/A (Form Name - LHWCA Prehearing Statement Form; Agency - Office of Administrative Law Judges)
- N/A (Form Name - LHWCA Uniform Stipulations Form; Agency - Office of Administrative Law Judges)
- N/A (Form Name - Manage/Update Diesel Inventory; Agency - Mine Safety and Health Administration)
- N/A (Form Name - Order Appointing Mediator; Agency - Office of Administrative Law Judges)
- N/A (Form Name - Report Commencement/Closure of Operation – Metal and Nonmetal Mines; Agency - Mine Safety and Health Administration)
- N/A (Form Name - Request for Appointment of Mediator; Agency - Office of Administrative Law Judges)
- N/A (Form Name - Safety and Health Complaint; Agency - Occupational Safety and Health Administration)
- N/A (Form Name - Settlement Judge Request; Agency - Office of Administrative Law Judges)
- N/A (Form Name - Wage Complaints; Agency - Wage and Hour Division)
- OWCP-01 (Form Name - Agreement and Undertaking (Self-Insured Employer; Agency - Office of Workers' Compensation Programs)
- OWCP-04 (Form Name - Uniform Billing Form; Agency - Office of Workers' Compensation Programs)
- OWCP-5a (Form Name - Work Capacity Evaluation Psychiatric/Psychological Conditions; Agency - Office of Workers' Compensation Programs)
- OWCP-5b (Form Name - Work Capacity Evaluation Cardiovascular/Pulmonary Conditions; Agency - Office of Workers' Compensation Programs)
- OWCP-5c (Form Name - Work Capacity Evaluation for Musculoskeletal Conditions; Agency - Office of Workers' Compensation Programs)
- OWCP-16 (Form Name - Rehabilitation Plan And Award; Agency - Office of Workers' Compensation Programs)
- OWCP-17 (Form Name - Rehabilitation Maintenance Certificate; Agency - Office of Workers' Compensation Programs)
- OWCP-20 (Form Name - Overpayment Recovery Questionnaire; Agency - Office of Workers' Compensation Programs)
- OWCP-44 (Form Name - Rehabilitation Action Report; Agency - Office of Workers' Compensation Programs)
- OWCP-915 (Form Name - Claim For Medical Reimbursement; Agency - Office of Workers' Compensation Programs)
- OWCP-957A – (Form Name - Medical Travel Refund Request – Mileage; Agency - Office of Workers' Compensation Programs)
- OWCP-957B – (Form Name - Medical Travel Refund Request – Expenses; Agency - Office of Workers' Compensation Programs)
- OWCP-1168 (Form Name - Provider Enrollment form; Agency - Office of Workers' Compensation Programs)
- OWCP-1500 (Form Name - Health Insurance Claim Form; Agency - Office of Workers' Compensation Programs)
- S-1 (Form Name - Surety Company Annual Report; Agency - Office of Labor-Management Standards)
- VETS-4212 (Form Name - Federal Contractor Reporting - Veteran Hiring; Agency - Veterans' Employment and Training Service)
- WH-2 (Form Name - Application for Special Industrial Homeworker Certificate; Agency - Wage and Hour Division)
- WH-4 (Form Name - H-1B Nonimmigrant Information; Agency - Wage and Hour Division)
- WH-5 (Form Name - Certificate of Training Form; Agency - Wage and Hour Division)
- WH-10 (Form Name - DBRA Report of Construction Contractor’s Wage Rates ; Agency - Wage and Hour Division)
- WH-46 (Form Name - Application for Certificateto Employ Homeworkers; Agency - Wage and Hour Division)
- WH-75 (Form Name - Homeworker Handbook ; Agency - Wage and Hour Division)
- WH-75 (Form Name - Homeworker Handbook (Spanish); Agency - Wage and Hour Division)
- WH-200 (Form Name - Application for Authority to Employ Full-Time Students at Subminimum Wages in Retail or Service Establishments or Agriculture Under Regulations 29 C.F.R. Part 519; Agency - Wage and Hour Division)
- WH-201 (Form Name - Higher Education to Employ its Full-time Students at Subminimum Wages Under Regulations 29 C.F.R. Part 519; Agency - Wage and Hour Division)
- WH-202 (Form Name - Application for Authority to Employ Six or Fewer Full-Time Students at Subminimum Wages in Retail or Service Establishments or Agriculture Under Regulations 29 C.F.R. Part 519; Agency - Wage and Hour Division)
- WH-205 (Form Name - Application to Employ Student-Learners at Subminimum Wages; Agency - Wage and Hour Division)
- WH-226 (Form Name - Application for Authority to Employ Workers with Disabilities at Subminimum Wages; Agency - Wage and Hour Division)
- WH-226A (Form Name - Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilities at Subminimum Wages; Agency - Wage and Hour Division)
- WH-347 (Form Name - DBRA Certified Payroll Form; Agency - Wage and Hour Division)
- WH-380-E (Form Name - FMLA Certification of Health Care Providerfor Employee’s Serious Health Condition; Agency - Wage and Hour Division)
- WH-380-F (Form Name - FMLA Certification of Health Care Providerfor Family Member’s Serious Health Condition; Agency - Wage and Hour Division)
- WH-381 (Form Name - FMLA Notice of Eligibility and Rights & Responsibilities; Agency - Wage and Hour Division)
- WH-382 (Form Name - FMLA Designation Notice; Agency - Wage and Hour Division)
- WH-384 (Form Name - FMLA Certification of Qualifying Exigency For Military Family Leave; Agency - Wage and Hour Division)
- WH-385 (Form Name - FMLA Certification for Serious Injury orIllness of Covered Servicemember -- for Military Family Leave; Agency - Wage and Hour Division)
- WH-385V (Form Name - FMLA Certification for Serious Injury or Illness of a Veteran for Wage and Hour Division Military Caregiver Leave; Agency - Wage and Hour Division)
- WH-501 (Form Name - MSPA Wage Statement; Agency - Wage and Hour Division)
- WH-501 (Form Name - MSPA Wage Statement (Spanish); Agency - Wage and Hour Division)
- WH-514 (Form Name - MSPA Vehicle Mechanical Inspection Report for Transportation Subjectto Department of Transportation Requirements ; Agency - Wage and Hour Division)
- WH-515 (Form Name - MSPA Doctor’s Certificate; Agency - Wage and Hour Division)
- WH-516 (Form Name - MSPA Worker Information – Terms of Employment ; Agency - Wage and Hour Division)
- WH-516 (Form Name - MSPA Worker Information – Terms of Employment (Haitian Creole); Agency - Wage and Hour Division)
- WH-516 (Form Name - MSPA Worker Information – Terms of Employment (Spanish); Agency - Wage and Hour Division)
- WH-520 (Form Name - MSPA Housing Occupancy Certificate; Agency - Wage and Hour Division)
- WH-521 (Form Name - MSPA Housing Terms and Conditions; Agency - Wage and Hour Division)
- WH-530 (Form Name - MSPA Application for a Farm Labor Contractor or Farm Labor ContractorEmployee Certificate of Registration; Agency - Wage and Hour Division)
- WH-530 (Form Name - MSPA Application for a Farm Labor Contractor or Farm Labor ContractorEmployee Certificate of Registration (Spanish); Agency - Wage and Hour Division)
- WH-1481 (Form Name - EPPA Notice to Examinee; Agency - Wage and Hour Division)
Forms By Agency
- AB-1 - Appeal Form
- 232 - Domestic Agricultural In- Season Wage Report
- 232A - Wage Survey Interview Record
- 385 - Domestic Agricultural In-season Wage Finding Process
- 750A - Application for Alien Employment Certification - Part A
- 750B - Application for Alien Employment Certification - Part B
- 790 - Agricultural and Food Processing Clearance Order
- 8429 - Complaint/Apparent Violation Form
- 9033 - Employers’ Attestation to Use Alien Crewmembers for Longshore Activities in U.S. Ports Form ETA 9033
- 9033-A - Employers’ Attestation to Use Alien Crewmembers for Longshore Activities in the State of Alaska
- 9035 - LCA Online Application
- 9089 - Application for Permanent Employment Certification
- 9127 - Foreign Labor Certification Quarterly Activity Report
- 9141 - Application for Prevailing Wage Determination
- 9141C - Application for Prevailing Wage Determination
- 9142A - H-2A Application for Temporary Employment Certification
- 9142B - H-2B Application for Temporary Employment Certification
- 9142C - CW-1 Application for Temporary Employment Certification
- 9165 - Employer-Provided Survey Attestations to Accompany H-2B Prevailing Wage Determination Request Based on a Non-OES Survey
- 2000-7 - Legal Identification Report
- 2000-38 - Electrically Operated Equipment Field Approval Application (Coal Only)
- 2000-222 - Self Contained Self Rescuer (SCSR) Inventory and Report
- 2000-224 - Operator’s Annual Certification of Mine Rescue Teams Qualifications
- 2000-238 - Representative of Miners Designation Form
- 4000-9 - Record of Individual Exposure to Radon Daughters
- 5000-1 - Certificate of Electrical/Noise Training
- 5000-3 - Certificate of Physical Qualification for Mine Rescue Work
- 5000-23 - Certificate of Training
- 5000-41 - Health Activity Certification or Hoisting Engineers Qualification Request
- 5000-46 - Request an MSHA Individual Identification Number (MIIN)
- 7000-1 - Mine Accident, Injury and Illness Report
- 7000-2 - Quarterly Mine Employment and Coal Production Report
- 7000-51 - Mine ID Request
- 7000-52 - Contractor ID Request
- N/A - Certificates of Achievement in Safety
- N/A - Electronic Training Plan Advisor
- N/A - Hazardous Condition Complaint
- N/A - Manage/Update Diesel Inventory
- N/A - Report Commencement/Closure of Operation – Metal and Nonmetal Mines
- N/A - Safety and Health Complaint
- N/A - Administrative Subpoena to Appear & Testify at a Deposition
- N/A - Administrative Subpoena to Appear & Testify at a Hearing
- N/A - Administrative Subpoena to Produce Documents, Information or Objects, or to Permit Inspection of Premises
- N/A - Agreement to Mediate
- N/A - Black Lung Benefits Act Evidence Summary Form
- N/A - LHWCA Prehearing Statement Form
- N/A - LHWCA Uniform Stipulations Form
- N/A - Order Appointing Mediator
- N/A - Request for Appointment of Mediator
- N/A - Settlement Judge Request
- N/A - Federal Contractor Discrimination Complaint
- N/A - Inspector General Hotline
- LM-1 - Labor Organization Information Report
- LM-2 - Labor Organization Annual Report
- LM-3 - Labor Organization Annual Report
- LM-4 - Labor Organization Annual Report
- LM-10 - Employer Report
- LM-15 - Trusteeship Report
- LM-15A - Report on Selection of Delegates and Officers
- LM-16 - Terminal Trusteeship Report
- LM-20 - Agreement and Activities Report
- LM-21 - Receipts and Disbursements Report
- LM-30 - Labor Organization Officer and Employee Report
- S-1 - Surety Company Annual Report
- OWCP-01 - Agreement and Undertaking (Self-Insured Employer)
- OWCP-04 - Uniform Billing Form
- OWCP-5a - Work Capacity Evaluation Psychiatric/Psychological Conditions
- OWCP-5b - Work Capacity Evaluation Cardiovascular/Pulmonary Conditions
- OWCP-5c - Work Capacity Evaluation for Musculoskeletal Conditions
- OWCP-16 - Rehabilitation Plan And Award
- OWCP-17 - Rehabilitation Maintenance Certificate
- OWCP-20 - Overpayment Recovery Questionnaire
- OWCP-44 - Rehabilitation Action Report
- OWCP-915 - Claim For Medical Reimbursement
- OWCP-957 - Medical Travel Refund Request
- OWCP-1168 - Provider Enrollment form
- OWCP-1500 - Health Insurance Claim Form
- CM-623 - Representative Payee Report
- CM-787 - Physician's/Medical Officer's Statement
- CM-893 - Certificate of Medical Necessity
- CM-908 - Notice of Termination, Suspension, Reduction or Increase in Benefit Payments
- CM-910 - Request To Be Selected As Payee
- CM-911 - Miner's Claim For Benefits Under The Black Lung Benefits Act
- CM-911a - Employment History
- CM-912 - Survivor's Form For Benefits Under The Black Lung Benefits Act
- CM-913 - Description Of Coal Mine Work and Other Employment
- CM-921 - Instructions For Completion of Form CM-921
- CM-929 - Report of Changes That May Affect Your Black Lung Benefits
- CM-929P - Report of Changes That May Affect Your Black Lung Benefits
- CM-933 - Roentgenographic Interpretation
- CM-933b - Roentgenographic Quality Rereading
- CM-936 - Authorization For Release Of Medical Information (Black Lung Benefits)
- CM-972 - Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by The U.S. Department of Labor
- CM-981 - Certification by School Official
- CM-988 - Medical History and Examination for Coal Mine Workers' Pneumoconiosis
- CM-1159 - Report of Arterial Blood Gas Study
- CM-2907 - Report of Ventilatory Study
- CM-2970 - Operator Response to Schedule for Submission of Additional Evidence
- CM-2970a - Operator Response to Notice of Claim
- CM-623S - Representative Payee Report
- CA-1 - Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation
- CA-2 - Notice of Occupational Disease and Claim for Compensation
- CA-2a - Notice of Recurrence
- CA-5 - Claim for Compensation by Widow, Widower, and/or Children
- CA-5b - Claim for Compensation by Parents, Brothers, Sisiters, GrandParents, or GrandChildren
- CA-6 - Official Supervisor's Report of Employee's Death
- CA-7 - Claim for Compensation
- CA-7a - Time Analysis Form, used for claiming compensation, including repurchase of paid leave
- CA-7b - Leave Buy Back (LBB) Worksheet/Certification and Election
- CA-10 - What A Federal Employee Should Do When Injured At Work
- CA-12 - Claim For Continuance of Compensation Under the Federal Employees' Compensation Act
- CA-17 - Duty Status Report
- en español: Informe de estado de servicio
- CA-20 - Attending Physician's Report
- en español: Informe del médico tratante
- CA-35 - Evidence Required in Support of a Claim for Occupational Disease
- CA-40 - Designation of a Recipient of the Federal Employees' Compensation Act Death Gratuity Payment under 5 U.S.C. § 8102a
- CA-41 - Claim for Survivor Benefits Under the Federal Employees’ Compensation Act Section 8102a Death Gratuity
- CA-42 - Official Notice of Employees’ Death for Purposes of FECA Section 8102a Death Gratuity
- CA-278 - Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act
- CA-721 - Notice of Law Enforcement Officer's Injury Or Occupational Disease
- CA-722 - Notice of Law Enforcement Officer's Death
- CA-1031 - Letter to Dependants to Verify Claimant Support
- CA-1074 - Letter to Parents in Death Claim Development
- CA-1108 - Statement of Recovery Letter with Long Form
- CA-1122 - Statement of Recovery Letter with Short Form
- CA-2231 - Claim for Reimbursement Assisted Reemployment
- LS-1 - Request for Examination and/or Treatment
- LS-4 - Attorney Fee Approval Request
- LS-5 - Application For Special Relief Fund
- LS-6 - Commutation Application
- LS-7 - Request for Intervention
- LS-8 - Settlement Approval Request Section 8(i)
- LS-9 - Stipulation Approval Request
- LS-18 - Pre-Hearing Statement
- LS-33 - Approval of Compromise of Third Person Cause of Action
- LS-200 - Report of Earnings
- LS-201 - Notice of Employee's Injury or Death
- LS-202 - Employer's First Report of Injury or Occupational Illness
- LS-203 - Employee's Claim for Compensation
- LS-204 - Attending Physician's Supplementary Report
- LS-206 - Payment of Compensation Without Award
- LS-207 - Notice of Controversion of Right to Compensation
- LS-208 - Notice of Final Payment or Suspension of Compensation Payments
- LS-210 - Employer's Supplementary Report of Accident or Occupational Illness
- LS-262 - Claim for Death Benefits
- LS-265 - Certification of Funeral Expenses
- LS-266 - Application for Continuation of Death Benefit for Student
- LS-267 - Claimant's Statement
- LS-271 - Application for Self-Insurance instructions
- LS-272 - Application to write Longshore Insurance (Carriers)
- LS-274 - Report of Injury Experience of Insurance Carrier or Self-Insured Employer
- LS-275ic - Agreement and Undertaking (Insurance Carrier)
- LS-275si - Agreement and Undertaking (Self-Insured Employer)
- LS-276 - Application for Security Deposit Determination. State Guarantee Fund Longshore Security Factor Chart
- LS-426 - Request for Earnings Information
- LS-513 - Report of Payments.
- LS-570 - Carrier's Report of Issuance of Policy (formerly Card Report of Insurance)
- LS-801 - Waiver of Service by Registered or Certified Mail for Employers and/or Insurance Carriers
- LS-802 - Waiver of Service by Registered or Certified Mail for Claimants and Authorized Representatives
- VETS-4212 - Federal Contractor Reporting - Veteran Hiring
- N/A - Wage Complaints
- WH-2 - Application for Special Industrial Homeworker Certificate
- WH-4 - H-1B Nonimmigrant Information
- WH-5 - Certificate of Training Form
- WH-10 - DBRA Report of Construction Contractor’s Wage Rates
- WH-46 - Application for Certificateto Employ Homeworkers
- WH-75 - Homeworker Handbook
- WH-75 - Homeworker Handbook (Spanish)
- WH-200 - Application for Authority to Employ Full-Time Students at Subminimum Wages in Retail or Service Establishments or Agriculture Under Regulations 29 C.F.R. Part 519
- WH-201 - Higher Education to Employ its Full-time Students at Subminimum Wages Under Regulations 29 C.F.R. Part 519
- WH-202 - Application for Authority to Employ Six or Fewer Full-Time Students at Subminimum Wages in Retail or Service Establishments or Agriculture Under Regulations 29 C.F.R. Part 519
- WH-205 - Application to Employ Student-Learners at Subminimum Wages
- WH-226 - Application for Authority to Employ Workers with Disabilities at Subminimum Wages
- WH-226A - Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilities at Subminimum Wages
- WH-347 - DBRA Certified Payroll Form
- WH-380-E - FMLA Certification of Health Care Providerfor Employee’s Serious Health Condition
- WH-380-F - FMLA Certification of Health Care Providerfor Family Member’s Serious Health Condition
- WH-381 - FMLA Notice of Eligibility and Rights & Responsibilities
- WH-382 - FMLA Designation Notice
- WH-384 - FMLA Certification of Qualifying Exigency For Military Family Leave
- WH-385 - FMLA Certification for Serious Injury orIllness of Covered Servicemember -- for Military Family Leave
- WH-385V - FMLA Certification for Serious Injury or Illness of a Veteran for Wage and Hour Division Military Caregiver Leave
- WH-501 - MSPA Wage Statement
- WH-501 - MSPA Wage Statement (Spanish)
- WH-514 - MSPA Vehicle Mechanical Inspection Report for Transportation Subjectto Department of Transportation Requirements
- WH-515 - MSPA Doctor’s Certificate
- WH-516 - MSPA Worker Information – Terms of Employment
- WH-516 - MSPA Worker Information – Terms of Employment (Haitian Creole)
- WH-516 - MSPA Worker Information – Terms of Employment (Spanish)
- WH-520 - MSPA Housing Occupancy Certificate
- WH-521 - MSPA Housing Terms and Conditions
- WH-530 - MSPA Application for a Farm Labor Contractor or Farm Labor ContractorEmployee Certificate of Registration
- WH-530 - MSPA Application for a Farm Labor Contractor or Farm Labor ContractorEmployee Certificate of Registration (Spanish)
- WH-1481 - EPPA Notice to Examinee