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United States Department of Labor Employees Compensation Appeals Board ___ C.S., Appellant and DEPARTMENT OF JUSTICE, BUREAU OF PRISONS, Atlanta, GA, Employer ___))))))))Appearances: Appellant, pro

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Write the date in the format MM/DD/YYYY at the top of the form.

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16-0101 hm refers to a specific form or report used by certain departments, typically related to tax or financial reporting.

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