(a) Claims and certain required submissions should be made on forms prescribed by OWCP. Persons submitting forms shall not modify these forms or use substitute forms.
| Form No.
| Title
|
|---|
| (1) EE-1 | Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act.
|
| (2) EE-2 | Claim for Survivor Benefits Under the Energy Employees Occupational Illness Compensation Program Act.
|
| (3) EE-3 | Employment History for a Claim Under the Energy Employees Occupational Illness Compensation Program Act.
|
| (4) EE-4 | Employment History Affidavit for a Claim Under the Energy Employees Occupational Illness Compensation Program Act. |
(b) Copies of the forms listed in this section are available for public inspection at the U.S. Department of Labor, Office of Workers' Compensation Programs, Washington, DC 20210. They may also be obtained from OWCP district offices and on the internet at http://www.dol.gov/owcp/energy/index.htm.
[71 FR 78534, Dec. 29, 2006, as amended at 84 FR 3047, Feb. 8, 2019]
source: 71 FR 78534, Dec. 29, 2006, unless otherwise noted.
cite as: 20 CFR 30.103