The CA-721 and CA-722 are used for filing claims for compensation for injury and death to non-Federal law enforcement officers under the provisions of 5 USC 8191 et seq. The forms provide the basic information needed to process the claims made for injury or death. The program requests clearance by the expiration date of March 31, 2020.
The latest form for Notice of Law Enforcement Officer's Injury or Occupational Disease and Notice of Law Enforcement Officer's Death expires 2023-10-31 and can be found here.
Document Name |
---|
Form and Instruction |
Justification for No Material/Nonsubstantive Change |
Justification for No Material/Nonsubstantive Change |
Supplementary Document |
Supplementary Document |
Supplementary Document |
Supplementary Document |
Supplementary Document |
Supplementary Document |
Supplementary Document |
Supplementary Document |
Supplementary Document |
Supporting Statement A |
Approved without change |
No material or nonsubstantive change to a currently approved collection | 2024-10-24 | |
Approved without change |
Extension without change of a currently approved collection | 2023-09-12 | |
Approved without change |
No material or nonsubstantive change to a currently approved collection | 2022-08-04 | |
Approved without change |
Revision of a currently approved collection | 2020-03-30 | |
Approved without change |
Revision of a currently approved collection | 2016-12-30 | |
Approved without change |
Revision of a currently approved collection | 2013-10-30 | |
Approved without change |
Revision of a currently approved collection | 2010-08-06 | |
Approved without change |
Extension without change of a currently approved collection | 2010-03-12 |