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Operator Response To Schedule For Submission Of Additional Evidence Form. This is a Official Federal Forms form and can be use in US Dept Of Labor.
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Tags: Operator Response To Schedule For Submission Of Additional Evidence, CM-2970, Official Federal Forms US Dept Of Labor,
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This report is authorized by the Black Lung Benefits Act as amended (30 U.S.C. 901 et seq.) (20 CFR 725.410). Please check
appropriate boxes below. While you are not required to respond, if you fail to do so within 30 days after the District Director's
issuance of the schedule for the submission of additional evidence naming you as a responsible operator, you shall be deemed
to have accepted liability for this claim (that is, that you will be responsible for payment of benefits to which the Claimant is finally
determined to be entitled) and to have waived your right to contest your liability in any further proceeding conducted with respect
to this claim. You also will be deemed to have contested the Claimant's entitlement to benefits.
A. Liability
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B. Claimant's Entitlement
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