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Application for Approval of a Representative's Fee in Black Lung Claim Proceedings Conducted by the U.S. Department of Labor
Application for Approval of a Representative's Fee in Black Lung Claim Proceedings Conducted by the U.S. Department of Labor
OMB: 1240-0011
IC ID: 13877
OMB.report
DOL/OWCP
OMB 1240-0011
ICR 202304-1240-002
IC 13877
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1240-0011 can be found here:
2024-01-31 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form CM-972
Application for Approval of a Representative's Fee in Black Lung Claim Proceedings Conducted by the U.S. Department of Labor
Form
CM-972 APPLICATION FOR APPROVAL OF A REPRESENTATIVE’S FEE IN A BLACK LUNG CLAIM PROCEEDING CONDUCTED BY THE U.S. DEPARTMENT OF LABOR
Updated Attorney Fee Application Form.docx
www.dol.gov/sites/dolgov/files/owcp/regs/compliance/cm-972.pdf
Form and Instruction
Information Collection (IC) Details
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