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| DOL Home > Find It! By Form > DOL Form |
DOL Form CA-17
Agency: |
OWCP-DFEC |
Title: |
DFEC CA-17, Duty Status Report |
Form Description: |
DFEC CA-17, Duty Status Report: This form is provided for the purpose of obtaining a medical duty status report for the injured employee. |
OMB Control Number: |
1215-0103 |