OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Death Gratuity

OMB 1215-0206 · DOL/ESA.

OMB 1215-0206

Latest Forms, Documents, and Supporting Material

Document Name
Form ca-42 Death Gratuity Official Notice of Employees' Death Form and Instruction
Form ca-41 Death Gratuity Claim for Survivor Benefits Form and Instruction
Form ca-40 Death Gratuity Beneficiary Designation Form and Instruction
DEPARTMENT OF LABOR 1215-AB66 Emergency Submission.doc Supplementary Document
dol-govt-1.doc Supplementary Document
2009 opm salary table (4).pdf Supplementary Document
2009 databases tables and calculators by subject 8-10-09.pdf Supplementary Document
Death Gratuity Forms Supporting Statement 8-27-2009.doc Supporting Statement A
Death Gratuity Official Notice of Employees' Death Form and Instruction
Death Gratuity Claim for Survivor Benefits Form and Instruction
Death Gratuity Beneficiary Designation Form and Instruction

All Historical Document Collections

200908-1215-001

Approved with change

New collection (Request for a new OMB Control Number)

2009-08-28