# 20 CFR § 702.202: Employer's report; form and contents

> Federal · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/ecfr-20-702.202

## Section

- **Citation:** 20 CFR § 702.202
- **Heading:** Employer's report; form and contents
- **Jurisdiction:** Federal
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** September 22, 2026
- **Source:** Publisher's official text
- **Location:** Title 20—Employees' Benefits > CHAPTER VI—OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR > SUBCHAPTER A—LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT AND RELATED STATUTES > PART 702—ADMINISTRATION AND PROCEDURE > Subpart B—Claims Procedures > Employer's Reports

## Text

The employer's report of an employee's injury or death shall be in writing and on a form prescribed by the Director for this purpose, and shall contain:
(a) The name, address and business of the employer;
(b) The name, address, occupation and Social Security Number (SSN) of the employee;
(c) The cause, nature, and other relevant circumstances of the injury or death;
(d) The year, month, day, and hour when, and the particular locality where, the injury or death occurred;
(e) Such other information as the Director may require.
(Approved by the Office of Management and Budget under control numbers 1215-0031 and 1215-0063)
[58 FR 68032, Dec. 23, 1993]

## Nearby sections

- [20 CFR § 702.201 § 702.201 Reports from employers of employee's injury or death.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.201.md)
- [20 CFR § 702.202 § 702.202 Employer's report; form and contents.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.202.md)
- [20 CFR § 702.203 § 702.203 Employer's report; how given.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.203.md)
- [20 CFR § 702.204 § 702.204 Employer's report; penalty for failure to furnish and or falsifying.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.204.md)
- [20 CFR § 702.205 § 702.205 Employer's report; effect of failure to report upon time limitations.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.205.md)
- [20 CFR § 702.211 § 702.211 Notice of employee's injury or death; designation of responsible official.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.211.md)
- [20 CFR § 702.212 § 702.212 Notice; when given; when given for certain occupational diseases.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.212.md)
- [20 CFR § 702.213 § 702.213 Notice; by whom given.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.213.md)
- [20 CFR § 702.214 § 702.214 Notice; form and content.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.214.md)
- [20 CFR § 702.215 § 702.215 Notice; how given.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.215.md)
- [20 CFR § 702.216 § 702.216 Effect of failure to give notice.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.216.md)
- [20 CFR § 702.217 § 702.217 Penalty for false statement, misrepresentation.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.217.md)
- [20 CFR § 702.221 § 702.221 Claims for compensation; time limitations.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.221.md)
- [20 CFR § 702.222 § 702.222 Claims; exceptions to time limitations.](https://www.frixlaw.com/law-library/statutes/ecfr-20-702.222.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/ecfr-20-702.202. Check the current official text before relying on it. Not legal advice.