Death Gratuity Official Notice of Employees' Death

Death Gratuity

OMB: 1240-0017

IC ID: 190297

Documents and Forms

Document Name Document Type
Form ca-42 Death Gratuity Official Notice of Employees' Death Form and Instruction
ca-42 Official Notice of Employees' Death for Purposes of FECA Section 8102a Death Gratuity CA-42.pdf www.dol.gov/owcp/dfec/regs/compliance/forms.htm Form and Instruction