United States Department of Labor
Index
- Administrative Subpoena to Appear & Testify at a Deposition
- 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
- Application to write Longshore Insurance (Carriers)
- Certification of Funeral Expenses
- Commutation Application
- Employer-Provided Survey Attestations to Accompany H-2B Prevailing Wage Determination Request Based on a Non-OES Survey
- Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation
- H-2B Application for Temporary Employment Certification
- Medical History and Examination for Coal Mine Workers' Pneumoconiosis
- MSPA Wage Statement (Spanish)
- Notice of Termination, Suspension, Reduction or Increase in Benefit Payments
- Physician's/Medical Officer's Statement
- Report of Payments.
- Roentgenographic Quality Rereading
- Wage Survey Interview Record
- Administrative Subpoena to Produce Documents, Information or Objects, or to Permit Inspection of Premises
- Application for Authority to Employ Workers with Disabilities at Subminimum Wages
- Approval of Compromise of Third Person Cause of Action
- Claim for Compensation
- Complaint/Apparent Violation Form
- Employer's First Report of Injury or Occupational Illness
- FMLA Certification for Serious Injury or Illness of a Veteran for Wage and Hour Division Military Caregiver Leave
- Health Insurance Claim Form
- Medical Requirements
- MSPA Worker Information – Terms of Employment
- Pre-Hearing Statement
- Report of Ventilatory Study
- Settlement Approval Request Section 8(i)
- Waiver of Service by Registered or Certified Mail for Claimants and Authorized Representatives
- Agreement and Undertaking (Insurance Carrier)
- Application for Certificateto Employ Homeworkers
- Attending Physician's Report
- CW-1 Application for Temporary Employment Certification
- Certificate of Electrical/Noise Training
- FMLA Certification for Serious Injury orIllness of Covered Servicemember -- for Military Family Leave
- Higher Education to Employ its Full-time Students at Subminimum Wages Under Regulations 29 C.F.R. Part 519
- Medical Travel Refund Request
- MSPA Worker Information – Terms of Employment (Haitian Creole)
- Health Activity Certification or Hoisting Engineers Qualification Request
- Provider Enrollment form
- Representative of Miners Designation Form
- Settlement Judge Request
- Waiver of Service by Registered or Certified Mail for Employers and/or Insurance Carriers
- Agreement and Undertaking (Self-Insured Employer)
- Application for Continuation of Death Benefit for Student
- Attending Physician's Supplementary Report
- Claim for Compensation by Widow, Widower, and/or Children
- DBRA Certified Payroll Form
- Employer's Supplementary Report of Accident or Occupational Illness
- FMLA Certification of Health Care Providerfor Employee’s Serious Health Condition
- Homeworker Handbook
- Miner's Claim For Benefits Under The Black Lung Benefits Act
- MSPA Worker Information – Terms of Employment (Spanish)
- Legal Identification Report
- Representative Payee Report
- Statement of Recovery Letter with Long Form
- What A Federal Employee Should Do When Injured At Work
- Agreement to Mediate
- Application for Permanent Employment Certification
- Attorney Fee Approval Request
- Claim For Continuance of Compensation Under the Federal Employees' Compensation Act
- Description Of Coal Mine Work and Other Employment
- Employers’ Attestation to Use Alien Crewmembers for Longshore Activities in the State of Alaska
- FMLA Certification of Health Care Providerfor Family Member’s Serious Health Condition
- Homeworker Handbook (Spanish)
- MSPA Application for a Farm Labor Contractor or Farm Labor ContractorEmployee Certificate of Registration
- Notice of Controversion of Right to Compensation
- Labor Organization Annual Report
- Rehabilitation Maintenance Certificate
- Representative Payee Report
- Statement of Recovery Letter with Short Form
- Work Capacity Evaluation Cardiovascular/Pulmonary Conditions
- Agricultural and Food Processing Clearance Order
- Application for Prevailing Wage Determination
- Authorization For Release Of Medical Information (Black Lung Benefits)
- Claim for Death Benefits
- Employers’ Attestation to Use Alien Crewmembers for Longshore Activities in U.S. Ports Form ETA 9033
- FMLA Certification of Qualifying Exigency For Military Family Leave
- Instructions For Completion of Form CM-921
- MSPA Application for a Farm Labor Contractor or Farm Labor ContractorEmployee Certificate of Registration (Spanish)
- Notice of Employee's Injury or Death
- Official Supervisor's Report of Employee's Death
- Rehabilitation Plan And Award
- Request for Appointment of Mediator
- Stipulation Approval Request
- Work Capacity Evaluation for Musculoskeletal Conditions
- Appeal Form
- Application for Security Deposit Determination. State Guarantee Fund Longshore Security Factor Chart
- Black Lung Benefits Act Evidence Summary Form
- Claim For Medical Reimbursement
- Domestic Agricultural In- Season Wage Report
- Employment History
- FMLA Designation Notice
- Leave Buy Back (LBB) Worksheet/Certification and Election
- MSPA Doctor’s Certificate
- Notice of Final Payment or Suspension of Compensation Payments
- Operator Response to Notice of Claim
- Report of Arterial Blood Gas Study
- Request for Earnings Information
- Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilities at Subminimum Wages
- Work Capacity Evaluation Psychiatric/Psychological Conditions
- Application for Alien Employment Certification - Part A
- Application for Self-Insurance instructions
- Carrier's Report of Issuance of Policy (formerly Card Report of Insurance)
- Claim for Reimbursement Assisted Reemployment
- Domestic Agricultural In-season Wage Finding Process
- Employment History
- FMLA Notice of Eligibility and Rights & Responsibilities
- Letter to Dependants to Verify Claimant Support
- MSPA Housing Occupancy Certificate
- Notice of Law Enforcement Officer's Death
- Operator Response to Schedule for Submission of Additional Evidence
- Report of Changes That May Affect Your Black Lung Benefits
- Request for Examination and/or Treatment
- Survivor's Claim
- Request an MSHA Individual Identification Number (MIIN)
- Application for Alien Employment Certification - Part B
- Application for Special Industrial Homeworker Certificate
- Certificate of Medical Necessity
- Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act
- Duty Status Report
- Employment History Affidavit
- Foreign Labor Certification Quarterly Activity Report
- Letter to Parents in Death Claim Development
- MSPA Housing Terms and Conditions
- Notice of Law Enforcement Officer's Injury Or Occupational Disease
- Order Appointing Mediator
- Report of Changes That May Affect Your Black Lung Benefits
- Request for Intervention
- Survivor's Form For Benefits Under The Black Lung Benefits Act
- Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by The U.S. Department of Labor
- Application For Special Relief Fund
- Certificate of Training Form
- Claim for Survivor Benefits Under the Federal Employees’ Compensation Act Section 8102a Death Gratuity
- Employee's Claim
- EPPA Notice to Examinee
- H-1B Nonimmigrant Information
- LHWCA Prehearing Statement Form
- MSPA Vehicle Mechanical Inspection Report for Transportation Subjectto Department of Transportation Requirements
- Notice of Occupational Disease and Claim for Compensation
- Overpayment Recovery Questionnaire
- Report of Earnings
- Request To Be Selected As Payee
- Time Analysis Form, used for claiming compensation, including repurchase of paid leave
- 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
- Application to Employ Student-Learners at Subminimum Wages
- Certification by School Official
- Claimant's Statement
- Employee's Claim for Compensation
- Evidence Required in Support of a Claim for Occupational Disease
- H-2A Application for Temporary Employment Certification
- LHWCA Uniform Stipulations Form
- MSPA Wage Statement
- Notice of Recurrence
- Payment of Compensation Without Award
- Report of Injury Experience of Insurance Carrier or Self-Insured Employer
- Roentgenographic Interpretation
- Uniform Billing Form
- 5500 Series
- Record of Individual Exposure to Radon Daughters
- Certificate of Training
- Mine ID Request
- Certificate of Physical Qualification for Mine Rescue Work
- LCA Online Application
- Electrically Operated Equipment Field Approval Application (Coal Only)
- Operator’s Annual Certification of Mine Rescue Teams Qualifications
- Mine Accident, Injury and Illness Report
- Self Contained Self Rescuer (SCSR) Inventory and Report
- Quarterly Mine Employment and Coal Production Report
- Administrative Subpoena to Appear & Testify at a Hearing
- Application for Prevailing Wage Determination