View ESA-OWCP-DFEC's Form 1215-0155 Online
Agency: |
ESA-OWCP-DFEC |
Title: |
DFEC CA-5b, Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren |
Form Description: |
DFEC CA-5b, Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren: A deceased federal employee's parents, grandparents or representative (custodian or guardian) of minor brothers, sisters, or grandchildren may use this form to claim benefits. |
OMB Control Number: |
1215-0155 |
OMB Expiration Date: |
Monday, May 31, 2010
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