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160 Forms found in Official Federal Forms — US Dept Of Labor — Page 3 of 4
Title Last Updated
Wage Statement July 1, 2008
Pre-Hearing Statement May 21, 2008
Request For MSHA Individual Identification Number (MIIN) April 29, 2008
Employees Claim For Compensation February 27, 2008
Supplemental Data Sheet For Application For Authority To Employ Workers With Disabilities At Special Wages February 13, 2008
Certificate Of Physical Qualification For Mine Rescue Work January 16, 2008
Request For Earnings Information November 27, 2007
Receipt For Payment Of Lost Or Denied Wages Employment Benefits Or Other Compensation September 27, 2007
Application For EFAST Electronic Signature Codes For EFAST Transmitters And Software Developers August 20, 2007
Claim For Reimbursement Assisted Reemployment August 20, 2007
Pretrial Statement (OALJ San Francisco District) June 8, 2007
Provider Enrollment Form June 8, 2007
Letter To Parents In Death Claim Development May 29, 2007
Letter To Dependants To Verify Claimant Support May 29, 2007
Claim For Compensation By Widow Widower And Or Children May 29, 2007
Claim For Compensation By Parents Brothers Sisters Grandparents Or Grandchildren May 29, 2007
Certification By School Official May 29, 2007
SCSR Inventory And Report May 22, 2007
Claim For Medical Reimbursement May 10, 2007
Uniform Health Insurance Claim April 11, 2007
Rehabilitation Maintenance Certificate January 29, 2007
Overpayment Recovery Questionnaire November 21, 2006
Statement Of Recovery Letter With Short Form July 19, 2006
Statement Of Recovery With Long Form July 19, 2006
Form LM-10 Employer Report Part 1 May 2, 2006
Form LM-10 Employer Report Part 2 May 2, 2006
Applicant Background Questionnaire February 9, 2006
Complaint Of Discrimination In Employment Under Federal Government Contracts December 16, 2005
Notice Of Alleged Safety Or Health Hazards October 7, 2005
Report Of Injury Experience Of Self-Insured Employer September 19, 2005
Operator Controversion September 19, 2005
Electrically Operated Mining Equipment Field Approval Application (Coal Operator) September 19, 2005
Coal Mine Employment Affidavit September 19, 2005
Operator Response September 19, 2005
Affidavit Of Deceased Miners Condition September 19, 2005
Subpoena (OALJ) May 26, 2005
Stipulation (OALJ Boston Distict) May 26, 2005
Request For Appointment Of Settlement Judge (OALJ) May 26, 2005
Black Lung Benefits Act Evidence Summary Form (OALJ) May 26, 2005
Pretrial Statement (OALJ Boston District) May 26, 2005
Approval Of Compromise Of Third Person Cause Of Action April 12, 2005
Eligibility Data Form April 5, 2005
Federal Employees Notice Of Traumatic Injury And Claim For Continuation Of Pay-Compensation March 31, 2005
Time Analysis Form February 18, 2004
Request For Examination And Or Treatment February 18, 2004
Report Of Termination Of Disability And Or Payment February 18, 2004
Report Of Payments February 18, 2004
Physicians Report On Impairment Of Vision February 18, 2004
Official Superiors Report Of Employees Death February 18, 2004
Notice Of Traumatic Injury Claim For Continuation Of Pay Compensation February 18, 2004