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Petitioner Appealing Final Decision under 42 CFR 83.18
EEOICPA Special Exposure Cohort Petition Forms (42 CFR Part 8)
Attachment D3 example of request for review
Petitioner Appealing Final Decision under 42 CFR 83.18
OMB: 0920-0639
OMB.report
HHS/CDC
OMB 0920-0639
ICR 201909-0920-003
IC 180185
Petitioner Appealing Final Decision under 42 CFR 83.18
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0639 can be found here:
2022-12-21 - Extension without change of a currently approved collection
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2013-04-30
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2013-04-30
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