Agency:

OWCP-DFEC

Title:

DFEC CA-5b, Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren

Form Description:

DFEC CA-5b, Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren: A deceased federal employee's parents, grandparents or representative (custodian or guardian) of minor brothers, sisters, or grandchildren may use this form to claim benefits.

OMB Control Number:

1215-0155

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