Application For Approval Of A Representative’s Fee In Black Lung Claims Proceedings Conducted By The U.s. Department Of Labor

Justification CM-972.docx

Application for Approval of a Representative's Fee in Black Lung Claim Proceedings Conducted by the U.S. Department of Labor

APPLICATION FOR APPROVAL OF A REPRESENTATIVE’S FEE IN BLACK LUNG CLAIMS PROCEEDINGS CONDUCTED BY THE U.S. DEPARTMENT OF LABOR

OMB: 1240-0011