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ICR 201509-1240-001 · OMB 1240-0014 · Object 58882301.

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Status: The document is viewable, but some background extraction is still pending.

Queue: Repair is queued and waiting for the next worker pass. (priority 140 · next 2026-08-04 20:13:57)

Missing: html

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Primary: docxSource: application/vnd.openxmlformats-officedocument.wordprocessingml.document
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Document Metadata

Record metadata
application/vnd.openxmlformats-officedocument.wordprocessingml.document
CHANGE WORKSHEET FOR OMB NO
US Department of Labor
2021-01-24
partial