Form B 42 CFR Part 83.9
EEOICPA Special Exposure Cohort Petition Forms (42 CFR Part 8)
Attachment D2 Example of Petition without Form B.rev 1
Form B 42 CFR Part 83.9
OMB: 0920-0639
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0639 can be found here:
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| File Type | application/pdf |
| File Modified | 2010-07-07 |
| File Created | 2010-07-07 |