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Request for Information on Earnings, Dual Benefits, Dependents, and Third Part Settlements
Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlements
OMB: 1240-0016
IC ID: 13834
OMB.report
DOL/OWCP
OMB 1240-0016
ICR 202304-1240-010
IC 13834
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1240-0016 can be found here:
2023-09-25 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form CA-1032
Request for Information on Earnings, Dual Benefits, Dependents, and Third Part Settlements
Form and Instruction
Form CA-1032
Request for Information on Earnings, Dual Benefits, Dependents, and Third Part Settlements
Form and Instruction
CA-1032 Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlement
Request for Information on Earnings Dual Benefits Dependents and Third Party Settlements (CA-1032).docx
Form and Instruction
Information Collection (IC) Details
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