ICR Documents

Supporting Statement A Document Date Uploaded ICR 1240-0019 - Supporting Statement A 2.25.22.docx 02/25/2022 Supporting Statement B Document Date Uploaded Supplementary Documents Title Document Document Type Date Uploaded 20 CFR 10.801 FECA 20 CFR 10.801 FECA - Supporting Reg.pdf Supplementary Document 11/05/2012 20 CFR 30.701 EEOICPA 20 CFR 30.701 EEOICPA Supporting Reg.pdf Supplementary Document 11/05/2012 20 CFR 725.405, 406, 701 and 705 BLBA 20 CFR 725.405, 406, 701 and 705 BLBA Supporting Reg.pdf Supplementary Document 11/05/2012 1240-0019 Uniform Billing Form (OWCP-04) 1240-0019 Unifirm Billing Form (OWCP-4) Highlighted Changes.pdf Supplementary Document 12/26/2023 Justification for 1240-0019 Uniform Billing Form (OWCP-04) Justification 1240-0019 Uniform Health Insurance Claim Form (OWCP-04).docx Justification for No Material/Nonsubstantive Change 12/26/2023 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received