OMB
.report
Search
Form CA-278 Claims for Reimbursement of Benefit Payments and Claims
Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act
CA-278 2.21.2023
Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act
OMB: 1240-0006
OMB.report
DOL/OWCP
OMB 1240-0006
ICR 202302-1240-004
IC 13940
Form CA-278 Claims for Reimbursement of Benefit Payments and Claims
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1240-0006 can be found here:
2023-05-01 - Extension without change of a currently approved collection
Document [file]
Download:
file
|
pdf
File Type
inode/x-empty
© 2024 OMB.report |
Privacy Policy