Rehabilitation Maintenance Certificate

ICR 202502-1240-004

OMB: 1240-0012

Federal Form Document

Forms and Documents

Document Name	Status
Form OWCP-17 Rehabilitation Maintenance Certificate Form	Modified
1240-0012 Supporting Statement 2025.docx Supporting Statement A	2025-03-21
Rehabilitation Counselors Wages.pdf Supplementary Document	2025-02-18
Office of Workers' Compensation Programs Longshore and Harbor Workers' Compensation Act Case Files.docx Supplementary Document	2025-02-18
Privacy Act Systems-FECA.docx Supplementary Document	2025-02-18
Office of Workers' Compensation Programs, Longshore and Harbor Worker's Compensation Act Special Fund System.docx Supplementary Document	2025-02-18

IC Document Collections

IC ID	Document Title	Status
43809	Rehabilitation Maintenance Certificate Form	Modified