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DOL Form CA-722

View OWCP-DFEC's Form CA-722 Online 

Agency:	OWCP-DFEC
Title:	DFEC CA-722, Notice of Law Enforcement Officer's Death
Form Description:	DFEC CA-722, Notice of Law Enforcement Officer's Death: This form is used to report the death of a law enforcement officer, including an attending physician's report. It may also be used to file a claim on behalf of a widow, widower, or children.
OMB Control Number:	1240-0022

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