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United States Department of Labor Employees Compensation Appeals Board ___ HELEN R. RAGLAND, Appellant and U.S. POSTAL SERVICE, POST OFFICE, Dallas, TX, Employer ___))))))))Appearances: Helen R. Ragland,

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To fill out Form 04-1919 Helen R. Ragland, follow these steps:

02

Start by entering the date in the 'Date' field at the top of the form.

03

In the 'Name' section, provide the full name 'Helen R. Ragland'.

04

Next, provide the complete address in the 'Address' field.

05

Enter the Social Security Number (SSN) in the designated space.

06

In the 'Employer' section, provide the name and address of the employer.

07

Fill out the 'Occupation' field with the occupation of the individual.

08

Provide the individual's 'Date of Birth'.

09

Indicate the 'Gender' by selecting the appropriate option.

10

If applicable, provide the 'Spouse's Full Name' and 'Spouse's SSN'.

11

Complete the 'Dependents' section by including the names and SSNs of any dependents.

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Sign and date the form at the bottom.

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Form 04-1919 Helen R. Ragland is required by individuals who need to report their personal information, such as name, address, Social Security Number, employer details, occupation, date of birth, gender, and information about dependents. This form may be needed for various purposes, such as employment, tax reporting, or government documentation.

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