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Notice of Law Enforcement Officer's Injury or Occupational Disease (CA-721); Notice of Law Enforcement Officer's Death (CA-722)
Notice of Law Enforcement Officer's Injury or Occupational Disease and Notice of Law Enforcement Officer's Death
OMB: 1240-0022
IC ID: 13785
OMB.report
DOL/OWCP
OMB 1240-0022
ICR 202305-1240-001
IC 13785
( )
Documents and Forms
Document Name
Document Type
Form CA-721
Notice of Law Enforcement Officer's Injury or Occupational Disease (CA-721); Notice of Law Enforcement Officer's Death (CA-722)
Form and Instruction
CA-721 Notice of Law Enforcement Officer's Injury or Occupational Disease
ca-721.docx
www.dol.gov/owcp/dfec/regs/compliance/forms.htm
Form and Instruction
CA-722 Notice of Law Enforcement Officer's Death
ca-722.docx
www.dol.gov/owcp/dfec/regs/compliance/forms.htm
Form and Instruction
Information Collection (IC) Details
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