Document
CM-912 - Survivor's Form For Benefits Under The Black Lung Benefits Act
ICR 202603-1240-004 · OMB 1240-0027 · Object 167586800.
Document Viewer [pdf]
Status: Original and derived artifacts are available for this document.
Download: pdf
Loading document viewer…
Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | CM-912 - Survivor's Form For Benefits Under The Black Lung Benefits Act |
| Author | U.S. Department of Labor |
| Last Modified By | Designer 6.5 |
| File Modified | 2026-03-31 |
| File Created | 2026-03-31 |
| Conversion State | complete |