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| Claim for Compensation by Parents, Brothers, Sisters, Grandparents or Grandchildren, Form CA-5b |
| Availability |
Pending Reprint Decision (Priced, No Stock Available in Warehouse or Retail) |
| Stock Number |
029-016-00186-7 |
| ISBN |
0-16-061792-8 |
| Price |
$48.50 |
| International Price |
$ 67.90 |
| Description |
Form CA-5b, Rev. Jan. 1997. Issued with perforations. Expires April 30, 1998. Includes form and instructions. Also includes attending physician's report. Sold in packages of 100 copies only. Item 0746-C. |
| Publisher |
Labor Dept., Employment Standards Administration, Office of Workers' Compensation Programs |
| Year/pages |
1997: 4 p. |
| Note |
Supersedes L 36.410:Ca-5b, S/N 029-016-00114-0. NB1262 |
| Key Phrases |
Form CA 5b, Workers Compensation, Survivors Benefits |
| SuDocs Class |
L 36.410:CA-5 B/997 |
| Author |
|
| Weight |
2 lbs. 1 oz. |
| Quantity Price |
Discount |
| Binding |
Paper Cover, Stitch |
| Cover |
Paper |
| Available Date |
09/04/97 |
| Subject Bibliography |
090MC |
| Status Date |
10/24/03 |
| Unit |
Package |
| Unit (non-U.S.) |
Each |
|
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