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Supporting Statement for 1240-0012 final
Supporting Statement for 1240-0012 final.docx
Rehabilitation Maintenance Certificate
OMB: 1240-0012
OMB.report
DOL/OWCP
OMB 1240-0012
ICR 202110-1240-001
Supporting Statement for 1240-0012 final
( Supporting Statement A )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1240-0012 can be found here:
2025-03-21 - Revision of a currently approved collection
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application/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title
OWCP-16February2002
Author
Sharpless, Marcus J - OWCP
File Modified
0000-00-00
File Created
2022-01-20
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