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DOL Form CA-5b

View OWCP-DFEC's Form CA-5b Online 

Agency:	OWCP-DFEC
Title:	DFEC CA-5b, Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren
Form Description:	DFEC CA-5b, Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren: A deceased federal employee's parents, grandparents or representative (custodian or guardian) of minor brothers, sisters, or grandchildren may use this form to claim benefits.
OMB Control Number:	1240-0013

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