OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Claim for Compensation by Dependents Information Reports

OMB 1215-0155 ยท DOL/ESA.

OMB 1215-0155

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form CA-1074 Claim for Compensation by Dependents Information ReportsForm
DOL-GOVT-1.pdf Supplementary Document
27 CFR Chapter 10.7 thru 10.537.pdf Supplementary Document
Table B-3 Average Hourly and Weekly Earnings.pdf Supplementary Document
Salary Table 2006-RUS.pdf Supplementary Document
Section 8110 Augmented Compensation for Dependents.pdf Supplementary Document
SS 1215-0155 10.10.06.docSupporting Statement A
Claim for Compensation by Dependents Information Reports Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
200610-1215-003 Extension without change of a currently approved collection 2007-03-01 Approved without change
200403-1215-002 Extension without change of a currently approved collection 2004-03-12 Approved without change
200102-1215-005 Extension without change of a currently approved collection 2001-02-22 Approved without change
199803-1215-001 Extension without change of a currently approved collection 1998-03-06 Approved without change
199501-1215-003 Extension without change of a currently approved collection 1995-01-31 Approved without change
199201-1215-002 Extension without change of a currently approved collection 1992-01-15 Approved without change
198901-1215-002 Revision of a currently approved collection 1989-01-25 Approved without change
198603-1215-005 Revision of a currently approved collection 1986-03-13 Approved without change
198403-1215-004 New collection (Request for a new OMB Control Number) 1984-03-12 Approved without change