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552a as amended. 1 Collection of this information is authorized by the Black Lung Benefits Act as amended 30 USC 901 et seq. DO NOT SEND THE COMPLETED FORM TO THIS OFFICE. Notice If you have a substantially limiting physical or mental impairment Federal disability nondiscrimination law gives you the right to receive help from DCMWC in the form of communication assistance accommodation and modification to aid you in the claims process. Miner s First Name Print M. I. 3. E-mail Address 6....
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Start by opening the miner's first name field in the form or application.
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If the miner has multiple first names, include all of them in the designated field, separated by a space or comma.
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Miner's first name refers to the given name of the individual who is under the legal age of adulthood.
Miner's first name is typically reported by their legal guardian or parent.
Miner's first name can be filled out on official forms or documents that require identification of the individual.
The purpose of stating miner's first name is to accurately identify the individual in legal and official documentation.
The information on miner's first name should include their actual given name as per their birth certificate or legal documents.
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