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Form LS-265.pdf

ls-265.pdf
Preview of Form LS-265
🔗 Source: dol.gov
📊 Size: 873 KB
👤 Author: U.S. Department of Labor
⬇️ Downloads: 25

Summary

The U.S. Department of Labor's Office of Workers' Compensation Programs uses Form LS-265 to determine payable funeral expenses under the Longshore and Harbor Workers' Compensation Act. The form requires information about the deceased, funeral services, and payments, and must be completed to obtain payment. Completed forms can be mailed or uploaded to the Secure Electronic Access Portal.

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Description

The U.S.

Technical Information

  • File Format: PDF
  • File Size: 873 KB
  • Pages: 1
  • Language: EN
  • Author: U.S. Department of Labor
  • Total Downloads: 25
  • Last Updated: 1 week ago

Document Overview

This PDF document about Form LS-265 provides comprehensive information and guidance. Whether you're a beginner or advanced user, this resource offers valuable insights into Form LS-265.

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