View ESA-OWCP-DFEC's Form 1215-0154 Online
Agency: |
ESA-OWCP-DFEC |
Title: |
DFEC CA-12, Claim For Continuance of Compensation Under the Federal Employees' Compensation Act |
Form Description: |
DFEC CA-12, Claim For Continuance of Compensation Under the Federal Employees' Compensation Act: Beneficiaries of deceased federal employees may complete and submit this form to request continuation of compensation under the Federal Employees' Compensation Act. |
OMB Control Number: |
1215-0154 |
OMB Expiration Date: |
Tuesday, May 31, 2011
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