OMB
.report
Search
Form CM-936 Authorization For Release of Medical Information (Black
Authorization for Release of Medical Information for Black Lung Benefits
CM-936 Form
Authorization for Release of Medical Information
OMB: 1240-0034
OMB.report
DOL/OWCP
OMB 1240-0034
ICR 202401-1240-009
IC 13694
Form CM-936 Authorization For Release of Medical Information (Black
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1240-0034 can be found here:
2024-12-12 - Revision of a currently approved collection
Document [html]
Download:
html
The system is under maintenance. It will be back shortly.
File Type
text/html
© 2025 OMB.report |
Privacy Policy