20 CFR § 702.214 - Notice; form and content.

---
identifier: "/us/cfr/t20/s702.214"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "20 CFR § 702.214 - Notice; form and content."
title_number: 20
title_name: "Employees' Benefits"
section_number: "702.214"
section_name: "Notice; form and content."
chapter_name: "OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR"
subchapter_number: "A"
subchapter_name: "LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT AND RELATED STATUTES"
part_number: "702"
part_name: "ADMINISTRATION AND PROCEDURE"
positive_law: false
currency: "2026-04-05"
last_updated: "2026-04-05"
format_version: "1.1.0"
generator: "[email protected]"
authority: "5 U.S.C. 301, and 8171  33 U.S.C. 901  42 U.S.C. 1651  43 U.S.C. 1333; 28 U.S.C. 2461 note (Federal Civil Penalties Inflation Adjustment Act of 1990); Pub. L. 114-74 at sec. 701; Reorganization Plan No. 6 of 1950, 15 FR 3174, 64 Stat. 1263; Secretary's Order 10-2009, 74 FR 58834."
regulatory_source: "38 FR 26861, Sept. 26, 1973, unless otherwise noted."
cfr_part: "702"
---


# 702.214 Notice; form and content.

Notice shall be in writing on a form prescribed by the Director for this purpose; such form shall be made available to the employee or beneficiary by the employer. The notice shall be signed by the person authorized to give notice, and shall contain the name, address and Social Security Number (SSN) of the employee and, in death cases, also the SSN of the person seeking survivor benefits, and a statement of the time, place, nature and cause of the injury or death.

[58 FR 68032, Dec. 23, 1993]