OMB control number
Claim for Medical Reimbursement Form
OMB 1215-0193 ยท DOL/ESA.
OMB 1215-0193
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form OWCP-915 Claim for Medical Reimbursement Form | Form and Instruction |
 Supporting stmt 1215-0193 2009 final.doc | Supporting Statement A |
 Claim for Medical Reimbursement Form |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 200907-1215-006 | Extension without change of a currently approved collection | 2009-11-17 | Approved without change | |
| 200608-1215-006 | Extension without change of a currently approved collection | 2007-01-03 | Approved without change | |
| 200506-1215-009 | No material or nonsubstantive change to a currently approved collection | 2005-06-29 | Approved without change | |
| 200311-1215-001 | Revision of a currently approved collection | 2003-11-25 | Approved without change | |
| 200011-1215-004 | Extension without change of a currently approved collection | 2000-11-28 | Approved without change | |
| 199712-1215-001 | New collection (Request for a new OMB Control Number) | 1997-12-17 | Approved without change |