Agency:

OWCP-EEOICP

Title:

EEOICP EE-2, Claim for Survivor Benefits under Energy Employees Occupational Illness Compensation Program Act

Form Description:

EEOICP EE-2, Claim for Survivor Benefits under Energy Employees Occupational Illness Compensation Program Act: Applicants use this form to submit a Survivor Claim under the Energy Employees Occupational Illness Compensation Program Act.

OMB Control Number:

1215-0197

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