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Statement of Recovery
Statement of Recovery Forms
OMB: 1240-0001
IC ID: 188783
OMB.report
DOL/OWCP
OMB 1240-0001
ICR 202404-1240-004
IC 188783
( )
Documents and Forms
Document Name
Document Type
Form CA-1122
Statement of Recovery
Form and Instruction
Form CA-1122
Statement of Recovery
Form and Instruction
CA-1122 Statement of Recovery
REVISED CA-1122 - SOL edits 4.17.24.clean version.pdf
www.dol.gov/agencies/owcp/FECA/regs/compliance/forms
Form and Instruction
Information Collection (IC) Details
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