EE-4 English Employment History Affidavit for a Claim Under the Energ
Energy Employees Occupational Illness Compensation Program Act Forms (Various)
EE-4 (8-31-07)
EEOICP Forms for Individuals or Households
OMB: 1240-0002
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1240-0002 can be found here:
Document [doc]
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doc |
pdf| File Type | application/msword |
| File Title | Claim for Benefits under Energy Employees |
| Author | US Department of Labor |
| Last Modified By | US Department of Labor |
| File Modified | 2006-07-11 |
| File Created | 2006-07-11 |