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Claim for Consequential Illness Benefits Under the Energy Employees Occupational Illness Compensation Program Act
OMB 1240-0063
OMB.report
DOL/OWCP
OMB 1240-0063
OMB 1240-0063
Latest Forms, Documents, and Supporting Material
Document
Name
Form EE-1 Claim for Consequential Illness Benefits under the Employees Occupational Illness Compensation Program Act
Form and Instruction
1240-0NEW_Supporting Statement_DEEOIC Consequential Illness Form (EE1-A)_FINAL.docx
Supporting Statement A
Claim for Consequential Illness Benefits under the Employees Occupational Illness Compensation Program Act
Form and Instruction
All Historical Document Collections
202405-1240-001
Approved with change
New collection (Request for a new OMB Control Number)
2024-05-29
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