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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
REPORT OF ACCIDENTAL INJURY IN SUPPORT OF CLAIM FOR COMPENSATION OR PENSION
Migrated
5000
2500
0
Form
21-4176
Total burden requested under this ICR:
5000
2500
0
To view an IC, click on IC Title
An official website of the United States government
The .gov means it's official.
The site is secure.
