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725.405
725.405.pdf
Authorization for Release of Medical Information for Black Lung Benefits
725.405
OMB: 1240-0034
OMB.report
DOL/OWCP
OMB 1240-0034
ICR 202401-1240-009
725.405
( Supplementary Document )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1240-0034 can be found here:
2024-12-12 - Revision of a currently approved collection
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