Forms Catalog Document - CM972 :-: ESA :-: Application for Approval of a Representative's Fee in Black Lung Claim Proceeding Conducted by The U.S. Department of Labor

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Application for Approval of a Representative's Fee in Black Lung Claim Proceeding Conducted by The U.S. Department of Labor

This form is used to collection pertinent data to determine if the representative's services and the amounts charged can be paid under the Black Lung Benefits Act.

Form #: CM 972
Agency: Department of Labor
Bureau: Employment Standards Administration
Common Name: CM-972

	TYPE	PAGES	SIZE (KB)	CAPABILITY	WHAT'S NEEDED
	Both Form and Instructions	2		[3] Fillable + Printable	Adobe Reader Download

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