OMB
.report
Search
MINER’S CLAIM for BENEFITS UNDER THE BLACK LUNG BENEFITS ACT CM-911 AND EMPLOYMENT HISTORY CM-911a
Justification CM-911 & CM-911a.docx
Miner's Claim for Benefits Under the Black Lung Benefits Act CM-911 and Employment History CM-911a
MINER’S CLAIM for BENEFITS UNDER THE BLACK LUNG BENEFITS ACT CM-911 AND EMPLOYMENT HISTORY CM-911a
OMB: 1240-0038
OMB.report
DOL/OWCP
OMB 1240-0038
ICR 202401-1240-012
MINER’S CLAIM for BENEFITS UNDER THE BLACK LUNG BENEFITS ACT CM-911 AND EMPLOYMENT HISTORY CM-911a
( Justification for No Material/Nonsubstantive Change )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1240-0038 can be found here:
2024-03-13 - No material or nonsubstantive change to a currently approved collection
Document [file]
Download:
file
|
pdf
File Type
inode/x-empty
© 2024 OMB.report |
Privacy Policy