OMB control number

Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act

OMB 1215-0202 · DOL/ESA.

OMB 1215-0202

Latest Forms, Documents, and Supporting Material

Document Name
Form CA-278 Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act Form
DOL_GOVT-1.doc Supplementary Document
SS for 1215-0202 CA-278 (January 2007).doc Supporting Statement A
Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act Form

All Historical Document Collections

200612-1215-003 Approved without change	Extension without change of a currently approved collection	2007-05-22
200402-1215-001 Approved without change	New collection (Request for a new OMB Control Number)	2004-02-19