Uniform Billing Claim Form

OMB 1215-0142 · DOL/ESA.

OMB 1215-0142

Latest Forms, Documents, and Supporting Material

Document Name
UNIFORM BILLING CLAIM FORM Form

All Historical Document Collections

198501-1215-003 Approved without change	Reinstatement with change of a previously approved collection	1985-01-31
198210-1215-001 Approved without change	New collection (Request for a new OMB Control Number)	1982-10-18