Document Type |
Form No. |
Form Name |
Instrument File |
URL |
Available Electronically? |
Can Be Submitted Electronically? |
Electronic Capability |
Form |
EE-8 |
Letter to Claimant
|
Form EE-8 and EN-8 lung.EXP 8-31-07.doc
|
|
No |
|
Paper Only |
Form |
EE-9 |
Letter to Claimant
|
Form EE-9 and EN-9 8-31-07.doc
|
|
No |
|
Paper Only |
Form and Instruction |
EE-4 English |
Employment History Affidavit for a Claim Under the Energy Employees Occupational Ilness Compensation Program Act
|
EE-4 (8-31-07).pdf
|
http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/claimsforms.htm |
Yes |
Yes |
Fillable Fileable Signable |
Form and Instruction |
EE-1 Spanish |
Energy Employees Occupational Illness Compensation Program Act Forms. (Various)
|
EE1-Spa (June 11, 2006).doc
|
http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/claimsforms.htm |
Yes |
Yes |
Fillable Fileable Signable |
Form and Instruction |
EE-3 Spanish |
Employment History for a Claim Under the Energy Employees Occupational Illness Compensation Program Act
|
EE3-Spa (July 11, 2006).doc
|
http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/claimsforms.htm |
Yes |
Yes |
Fillable Fileable Signable |
Form and Instruction |
EE-3 English |
Employment History for a Claim Under the Energy Employees Occupational Illness Compensation Program Act
|
EE-3 (8-31-07).pdf
|
http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/claimsforms.htm |
Yes |
Yes |
Fillable Fileable Signable |
Form and Instruction |
EE-2 Spanish |
Claim for Survivor Benefits Under the Energy Employees Occupational Illness Compensation Program Act
|
EE2-Spa (July 11, 2006).doc
|
http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/claimsforms.htm |
Yes |
Yes |
Fillable Fileable Signable |
Form and Instruction |
EE-4 Spanish |
Employment History Affidavit for a Claim under the Energy Employees Occupational Illness Compensation Program Act
|
EE4-Spa.doc
|
http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/claimsforms.htm |
Yes |
Yes |
Fillable Fileable Signable |
Form and Instruction |
EE-2 English |
Claim for Survivor Benefits Under the Energy Employees Occupational Illness Compensation Program Act
|
EE-2 (8-31-07).pdf
|
http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/claimsforms.htm |
Yes |
Yes |
Fillable Fileable Signable |
Form and Instruction |
EE-20 |
Letter to Claimant
|
EN-20 (8-31-07).pdf
|
|
Yes |
Yes |
Fillable Fileable Signable |
Form and Instruction |
EE-1 English |
Claims for Benefits Under the Energy Employees Occupational Illness Compensation Program Act
|
EE-1 (8-31-07).pdf
|
http://www.dol.gov./esa/regs/compliance/owcp/eeoicp/clainsforms.htm |
Yes |
Yes |
Fillable Fileable Signable |
Form and Instruction |
EE-10 |
Claim for Additional Wage-Loss and/or Impairment Under the Energy Employees Occupational Illness Compensation Act
|
EE-10 8-31-07.pdf
|
|
No |
|
Paper Only |
Other-Letter |
|
|
EE-12 and EN-12 (draft) (2007 clearance).doc
|
|
No |
|
Paper Only |