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Request for Emergency Processing for ICR 202002-1240-0021
Signed Emergency Memo - 2-13-20.pdf
Provider Enrollment Form
Request for Emergency Processing for ICR 202002-1240-0021
OMB: 1240-0021
OMB.report
DOL/OWCP
OMB 1240-0021
ICR 202004-1240-004
Request for Emergency Processing for ICR 202002-1240-0021
( Supplementary Document )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1240-0021 can be found here:
2023-10-03 - Revision of a currently approved collection
2023-01-20 - No material or nonsubstantive change to a currently approved collection
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2020-02-14
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2020-02-14
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