OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Notice of Law Enforcement Officer's Injury or Occupational Disease (CA-721); Notice of Law Enforcement Officer's Death (CA-722)

OMB 1215-0116 · DOL/ESA.

OMB 1215-0116

Latest Forms, Documents, and Supporting Material

Document Name
Form CA-721 Notice of Law Enforcement Officer's Injury or Occupational Disease (CA-721); Notice of Law Enforcement Officer's Death (CA-722) Form and Instruction
Sections 10 .735 to 10.741 Non-Federal Law Enforcement Officers.doc Supplementary Document
THE PRIVACY ACT OF 1974.doc Supplementary Document
LAW 8191.doc Supplementary Document
DOL GOVT-1.pdf Supplementary Document
SS for 1215-0116 (CA-721 and 722) February 2007.doc Supporting Statement A
Notice of Law Enforcement Officer's Injury or Occupational Disease (CA-721); Notice of Law Enforcement Officer's Death (CA-722) Form and Instruction

All Historical Document Collections

200701-1215-009 Approved without change	Extension without change of a currently approved collection	2007-06-14
200406-1215-003 Approved without change	Extension without change of a currently approved collection	2004-06-15
200107-1215-002 Approved without change	Extension without change of a currently approved collection	2001-07-09
199807-1215-004 Approved without change	Extension without change of a currently approved collection	1998-07-28
199506-1215-006 Approved without change	Extension without change of a currently approved collection	1995-06-21
199205-1215-001 Approved without change	Revision of a currently approved collection	1992-05-11
198905-1215-001 Approved without change	Extension without change of a currently approved collection	1989-05-11
198605-1215-010 Approved without change	Extension without change of a currently approved collection	1986-05-30
198312-1215-001 Approved without change	Extension without change of a currently approved collection	1983-12-29
198110-1215-002 Approved without change	New collection (Request for a new OMB Control Number)	1981-10-20