Form CM-929 Report of Changes That May Affect Your Black Lung Benefi

Report of Changes That May Affect Your Black Lung Benefits

929 updated form

Report of Changes That May Affect Your Black Lung Benefits

OMB: 1240-0028

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1240-0028 can be found here:

2024-12-03 - No material or nonsubstantive change to a currently approved collection
2024-07-17 - No material or nonsubstantive change to a currently approved collection

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