View ESA-OWCP-DCMWC's Form 1215-0171 Online
Agency: |
ESA-OWCP-DCMWC |
Title: |
CM-972, Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by The of Labor |
Form Description: |
CM-972, Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by The U.S. Department of Labor: The CM-972 is used by a claimant’s representative to request a fee for legal services performed in connection with a claim for black lung benefits. |
OMB Control Number: |
1215-0171 |
OMB Expiration Date: |
Friday, December 31, 2010
|
| |
|