Claim for Consequential Illness Benefits Under the Energy Employees Occupational Illness Compensation Program Act

ICR 202405-1240-001

OMB: 1240-0063

Federal Form Document

Forms and Documents

Document Name	Status
Form EE-1 Claim for Consequential Illness Benefits under the Employees Occupational Illness Compensation Program Act Form and Instruction	New
1240-0NEW_Supporting Statement_DEEOIC Consequential Illness Form (EE1-A)_FINAL.docx Supporting Statement A	2024-05-22

IC Document Collections

IC ID	Document Title	Status
267380	Claim for Consequential Illness Benefits under the Employees Occupational Illness Compensation Program Act Form and Instruction	New