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E-mail This PageDOL Form CA-722
Agency: |
OWCP-DFEC |
Title: |
DFEC CA-722, Notice of Law Enforcement Officer's Death |
Form Description: |
DFEC CA-722, Notice of Law Enforcement Officer's Death: This form is used to report the death of a law enforcement officer, including an attending physician's report. It may also be used to file a claim on behalf of a widow, widower, or children. |
OMB Control Number: |
1215-0116 |
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