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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 202402-1240-002
MINER’S CLAIM for BENEFITS UNDER THE BLACK LUNG BENEFITS ACT CM-911 AND EMPLOYMENT HISTORY CM-911a
( Justification for No Material/Nonsubstantive Change )
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