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U. S. DEPARTMENT OF LABOREmployees Compensation Appeals Board In the Matter of SALLY OWEN, claiming as the widow of WILLIAM D. OWEN and DEPARTMENT OF THE ARMY, PINE BLUFF ARSENAL, Pine Bluff, AR Docket

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How to fill out 99-0928 sally owen claiming

01

To fill out the 99-0928 form for Sally Owen claiming, follow these steps:

02

Gather all the necessary information and supporting documents related to Sally Owen's claim.

03

Start by providing the personal details of Sally Owen in the designated sections of the form, such as her full name, address, contact information, and Social Security number.

04

Fill out the relevant sections of the form that require information about the claim, such as the type of benefits being claimed, the date of the incident or injury, and any other relevant details.

05

Attach any supporting documents, such as medical records, accident reports, or other evidence that substantiates Sally Owen's claim.

06

Double-check all the information filled in the form for accuracy and completeness.

07

Sign and date the form in the designated section to certify the accuracy of the provided information.

08

Submit the filled-out form along with the supporting documents to the appropriate authority or organization handling the claim.

09

Keep a copy of the filled-out form and supporting documents for your records.

Who needs 99-0928 sally owen claiming?

01

Anyone who needs to file a claim on behalf of Sally Owen can make use of the 99-0928 form. This form is specifically designed for those who need to submit a claim for Sally Owen's benefits or compensation. It may include individuals such as lawyers or representatives acting on behalf of Sally Owen, family members, or authorized agents. It is important to ensure that the person filling out the form has the necessary authority and permission to do so.

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What is 99-0928 sally owen claiming?

Sally Owen is claiming expenses related to medical bills and lost wages.

Who is required to file 99-0928 sally owen claiming?

Sally Owen herself is required to file the claim.

How to fill out 99-0928 sally owen claiming?

The form must be completed with accurate information regarding expenses and supporting documentation.

What is the purpose of 99-0928 sally owen claiming?

The purpose is to seek reimbursement for medical bills and lost wages due to a specific incident.

What information must be reported on 99-0928 sally owen claiming?

Information such as the date of the incident, medical provider information, and total expenses incurred.

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