U.S. Department of Labor (DOL CA EEO LS LM & MSHA) Forms in Word

Form	Description	Price	Buy Now
CA-1 Form	DFEC CA-1, Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation	$19.99
CA-2 Form	DFEC CA-2, Notice of Occupational Disease and Claim for Compensation	$19.99
CA-2 Form	DFEC CA-20, Attending Physician’s Report	$19.99
CA-2a Form	DFEC CA-2a, Notice of Recurrence	$19.99
CA-35 (A-H) Form	DFEC CA-35, Evidence Required in Support of a Claim for Occupational Disease (17 pages)	$19.99
CA-5 Form	DFEC CA-5, Claim for Compensation by Widow, Widower, and/or Children	$19.99
CA 5a Form	DFEC CA-5b, Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren	$19.99
CA-6 Form	DFEC CA-6, Official Supervisor’s Report of Employee’s Death	$19.99
CA-7 Form	DFEC CA-7, Claim for Compensation	$19.99
CA-7A Form	DFEC CA-7a, Time Analysis Form	$19.99
CA-7b Form	DFEC CA-7b, Leave Buy Back (LBB) Worksheet/Certification and Election	$19.99
CA 10 Form	DFEC CA-10, What A Federal Employee Should Do When Injured At Work	$19.99
CA 12 Form	DFEC CA-12, Claim For Continuance of Compensation Under the Federal Employees’ Compensation Act	$19.99
CA-17 Form	DFEC CA-17, Duty Status Report	$19.99
CA 278 Form	DFEC CA-278, Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act	$19.99
CA 721 Form	DFEC CA-721, Notice of Law Enforcement Officer’s Injury Or Occupational Disease	$19.99
CA722 Form	DFEC CA-722, Notice of Law Enforcement Officer’s Death	$19.99
CA 1031 Form	DFEC CA-1031, Letter to Dependants to Verify Claimant Support	$19.99
CA 1074 Form	DFEC CA-1074, Letter to Parents in Death Claim Development	$19.99
CA 1108 Form	DFEC CA-1108, Statement of Recovery Letter with Long Form	$19.99
CA 1122 Form	DFEC CA-1122, Statement of Recovery Letter with Short Form	$19.99
CA 2231 Form	DFEC CA-2231, Claim for Reimbursement Assisted Reemployment	$19.99
CC-4 Form	Complaint of Discrimination in Employment Under Federal Government Contracts	$40
CC-257 Form in WORD	Monthly Employment Utilization Report	$19.99
CC-257 Form in EXCEL	Monthly Employment Utilization Report	$19.50
CM-1093 Form	CM-1093, Affidavit of Deceased Miner’s Condition	$19.99
CM-1159 Form	CM-1159, Report of Arterial Blood Gas Study	$19.99
CM-2907 Form	CM-2907, Report of Ventilatory Study	$19.99
CM-2970 Form	CM-2970, Operator Response to Schedule for Submission of Additional Evidence	$19.99
CM-2970a Form	CM-2970a, Operator Response to Notice of Claim	$19.99
CM-623 Form	CM-623, Representative Payee Report	$19.99
CM-623S Form	CM-623S, Representative Payee Report	$19.99
CM-787 Form	CM-787, Physician’s/Medical Officer’s Statement	$19.99
CM-893 Form	CM-893, Certificate of Medical Necessity	$19.99
CM-908 Form	CM-908, Notice of Termination, Suspension, Reduction or Increase in Benefit Payments	$19.99
CM-910 Form	CM-910, Request To Be Selected As Payee	$19.99
CM-911 Form	CM-911, Miner’s Claim For Benefits Under The Black Lung Benefits Act	$40
CM-911a Form	CM-911a, Employment History	$19.99
CM-912 Form	CM-912, Survivor’s Form For Benefits Under The Black Lung Benefits Act	$19.99
CM-913 Form	CM-913, Description Of Coal Mine Work and Other Employment	$40
CM-918 Form	CM-918, Coal Mine Employment Affidavit	$19.99
CM-929 Form	CM-929, Report of Changes That May Affect Your Black Lung Benefits	$19.99
CM-933 Form	CM-933, Roentgenographic Interpretation	$19.99
CM-933b Form	CM-933b, Roentgenographic Quality Rereading	$19.99
CM-936 Form	CM-936, Authorization For Release Of Medical In Formation (Black Lung Benefits)	$19.99
CM-936 Form	Authorization For Release of Medical In Formation (Black Lung Benefits (Black Lung Benefits)	$19.99
CM-957 Form	The claimant completes the CM 957 to verify out of pocket medical travel expenses and to request reimbursement for these expenses. The in Formation also ensures that the travel expenses are related to the miner’s black lung condition.	$19.99
CM-970 Form	CM-970, Operator Controversion	$19.99
CM-970a Form	CM-970a, Operator Response	$19.99
CM-972 Form	CM-972, Application for Approval of a Representative’s Fee in a Black Lung Claim Proceeding Conducted by The of Labor	$19.99
CM-981 Form	CM-981, Certification by School Official	$19.99
CM-988 Form	CM-988, Medical History and Examination for Coal Mine Workers’ Pneumoconiosis	$40
DOL RNO-1 Form	APPLICANT BACKGROUND QUESTIONNAIRE-DOLRNO1 Form	$7.99
EEO-1 Form	Equal Employment Opportunity Form 1 Form	$7.99
EEOICP EE1 Form	EEOICP EE-1, Claim for Benefits under Energy Employees Occupational Illness Compensation Program Act	$19.99
EEOICP EE2 Form	EEOICP EE-2, Claim for Survivor Benefits under Energy Employees Occupational Illness Compensation Program Act	$19.99
EEOICP EE3 Form	EEOICP EE-3, Employment History for Claim Under Energy Employees Occupational Illness Compensation Program Act	$19.99
EEOICP EE4 Form	EEOICP EE-4, Employment History Affidavit for Claim Under Energy Employees Occupational Illness Compensation Program Act	$19.99
EEOICP EE5 Form	EEOICP EE-7, Medical Requirements under the Energy Employees Occupational Illness Compensation Program Act	$19.99
ETA-9081 Form	The Nursing Relief for Disadvantaged Areas Act of 1999 (NRDAA)	$19.99
ETA-750A Form	Application for Alien Employment Certification (Part A) (Note: Form ETA-750A is two-sided and must be ted two-sided.)	$19.99
ETA-750B Form	Application for Alien Employment Certification (Part B)	$19.99
ETA 790	Agricultural and Food Prrocessing Clearance Order -11 pages (3/19 expiration date)	$39.00
ETA 9033	Attestation by Employers using Alien Crewmembers for Longshore Activities in U.S. Ports	$19.99
ETA 9033-A	Attestation by Employers Using Alien Crewmembers for Longshore Activities At Locations in the State of Alaska	$19.99
ETA 9035 Form	ETA-9035 H-1B Specialty (Professional) Workers	$19.99
ETA 9035CP Form	Labor Condition Application and Requirements for Employer Using Nonimmigrants on H-1B Visas OMB 1205-0310	$19.99
ETA 9081 Form	H-1C Nurses for Disadvantaged Areas	$19.99
ETA 9089	Application for Permanent Employment Certification	$25.50
ETA 9127	Foreign Labor Certification Quarterly Activity Report	$19.99
ETA 9141	Application for Prevailing Wage Determination	$19.99
ETA 9142	Application for Temporary Employment Certification	$25.50
ETA 9142 A.1 and A.2	Application for Temporary Employment Certification-Appendix A.1 and A.2	$19.99
ETA 9142 B.1	Application for Temporary Employment Certification-Appendix B.1	$19.99
LM-1 Form	Form LM-1 Labor Organization In Formation Report	$89.99
LM 2 Form	Form LM-2 Labor Organization Annual Report	$89.99
LM3 Form	Form LM-3 Labor Organization Annual Report	$89.99
LM4 Form	Form LM-4 Labor Organization Annual Report	$89.99
LM 10 Form	Form LM-10 Employer Report	$21.99
LM 15 Form	Form LM-15 Trusteeship Report	$40
LM 15A Form	Form LM-15A Report on Selection of Delegates and Officers	$19.99
LM-16 Form	Form LM-16 Terminal Trusteehip Report	$19.99
LM-20 Form	Form LM-20 Agreement and Activities Report (Consultant)	$19.99
LM-21 Form	Form LM-21 Receipts and Disbursements Report (Consultant)	$19.99
LM-30 Form	Form LM-30 Labor Organization Officer and Employee Report	$19.99
LS-1 Form	DLHWC (Longshore) LS-1, Request for Examination and/or Treatment	$19.99
LS-18 Form	DLHWC (Longshore) LS-18, Pre-Hearing Statement	$19.99
LS-33 Form	DLHWC (Longshore) LS-33, Approval of Compromise of Third Person Cause of Action	$19.99
LS-200 Form	DLHWC (Longshore) LS-200, Report of Earnings	$19.99
LS-201 Form	DLHWC (Longshore) LS-201, Notice of Employee’s Injury or Death	$19.99
LS-202 Form	DLHWC (Longshore) LS-202, Employer’s First Report of Injury or Occupational Illness	$19.99
LS-203 Form	DLHWC (Longshore) LS-203, Employee’s Claim for Compensation	$19.99
LS-204 Form	DLHWC (Longshore) LS-204, Attending Physician’s Supplementary Report	$19.99
LS-205 Form	DLHWC (Longshore) LS-205, Physician’s Report on Impairment of Vision	$19.99
LS-206 Form	DLHWC (Longshore) LS-206, Payment of Compensation Without Award	$19.99
LS-207 Form	DLHWC (Longshore) LS-207, Notice of Controversion of Right to Compensation	$19.99
LS-208 Form	DLHWC (Longshore) LS-208, Notice of Final Payment or Suspension of Compensation Payments	$19.99
LS-210 Form	DLHWC (Longshore) LS-210, Employer’s Supplementary Report of Accident or Occupational Illness	$19.99
LS-262 Form	DLHWC (Longshore) LS-262, Claim for Death Benefits	$19.99
LS-265 Form	DLHWC (Longshore) LS-265, Certification of Funeral Expenses	$19.99
LS-266 Form	DLHWC (Longshore) LS-266, Application for Continuation of Death Benefit for Student	$19.99
LS-267 Form	DLHWC (Longshore) LS-267, Claimant’s Statement	$19.99
LS-271 Form	DLHWC (Longshore) LS-271, Application for Self-Insurance	$19.99
LS-274 Form	DLHWC (Longshore) LS-274, Report of Injury Experience of Insurance Carrier or of Self-Insured Employer	$19.99
LS-276 Form	DLHWC (Longshore) LS-276, Application for Security Deposit Determination	$19.99
LS-426 Form	DLHWC (Longshore) LS-426, Request for Earnings In Formation	$19.99
MSHA 1219-0007 Form	DOL Form MSHA 7000-2 Quarterly Mine Employment and Coal Production Report	$19.99
MSHA 1219-0007 Form	MSNA DOL Form 7000-1 Mine Accident, Injury and Illness Report	$19.99
MSHA 1219-0042 Form	DOL Form 2000-7 Legal Identification (ID) Report	MUST BE FILED ONLINE	Seethis link for more info.
MSHA 1219-0040 Form	DOL Form 7000-52 Contractor Identification (ID) Request	$19.99
MSHA 1219-0042 Form	DOL Form 2000-7 MSHA Notification of Representative of Miners	$19.99
MSHA 1219-0007 Form	Quarterly Mine Employment and Coal Production Report	$19.99
MSHA 1219-0003 Form	DOL Form 4000-9 Record of Individual Exposure to Radon Daughters	$19.99
MSHA 1219-0001 Form	DOL Form 5000-1 Certificate of Electrical/Noise Training	$19.99
MSHA 1219-0078 Form	DOL Form 5000-3 Certification of Physical Qualification for Mine Rescue Work	$19.99
MSHA 1219-0070 Form	DOL Form 5000-41 Certificate of Training	$19.99
MSHA 1219-0127 Form	Health Activity Certification or Hoisting Engineers Qualification Request Form	$19.99
MSHA 2000-7 Form	Legal Identification Report	$19.99
MSHA 1219-0066 Form	DOL Form 2000-38 Electrically Operated Mining Equipment Field Approval Application (Coal Operator)	$19.99
OWCP1 Form	OWCP-1 Agreement and Undertaking	$19.99
OWCP1168 Form	OWCP-1168, Black Lung Provider Enrollment Form	$19.99
OWCP957 Form	OWCP-957, Medical Travel Refund Request	$19.99
OWCP-915 Form	OWCP-915, Miner Medical Reimbursement Form	$19.99
OWCP-1500 Form	Health Insurance Claim Form(One of our best sellers!)	$19.99
S1 Form	S-1 Surety Company Annual Report	$19.99
T1 Form	Form T-1 Trust Annual Report	$19.99
UB-92	DOL UB92 Form: Uniform Health Insurance Claim Form	$19.99
VETS-100 Form	Federal Contractor Veterans’ Employment Report	$19.99
VETS-1010 Form	Eligibility Data Form: Uniformed Services Employment and Reemployment Rights Act and Veterans’ Preference	$19.99
WH-226 Form	TApplication for Authority to Employ Workers with Disabilities at Special Minimum Wages	$19.99
WH-226A Form	Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilities at Special Minimum Wages	$19.99
WH-348 Form	Certified Payroll Form-Additional Form included in our WH347 package;Click here to see Certified Payroll order Page	$19.99	See our CPR Page.
WH-347 in Excel	Federal Form (U.S. Dept. of Labor) US DOL WH347 & WH348 in Excel & Word (see PDF here)(OUR BEST SELLER!)Click here to see instructions by DOL.	$19.99
WH-347 in Word	Certified Payroll Form in Word-WH 347& WH348 in Word only	$19.99
WH-380 Form	The Certification of Health Care Provider	$40.00
WH-381 Form	Employer Response to Employee Request for Family and Medical Leave	$19.99
WH-382 (New!) Form	Designation Notice (Family and Medical Leave Act) Form	$19.99
WH-4 Form	H-1B Non-Immigrant In Formation Form	$19.99
WH-501 Forms in Word	The Wage Statement for Migrant and Seasonal Agricultural Workers IN WORD	$19.99
WH-501 Form IN EXCEL	The Wage Statement for Migrant and Seasonal Agricultural Workers IN EXCEL	$19.99
WH-501S Form	Spanish-language version of the Wage Statement for Migrant and Seasonal Agricultural Workers.	$19.99
WH-516 English Form	The Migrant and Seasonal Agricultural Worker In Formation Form	$19.99
WH-516 Spanish	Spanish-language version Migrant and Seasonal Agricultural Worker In Formation Form.	$19.99

DOL Forms – Department of Labor Microsoft Word Forms

U.S. Department of Labor (DOL CA EEO LS LM & MSHA) Forms in Word

CA-1 Form

CA-2 Form

CA-2 Form

CA-2a Form

CA-35 (A-H) Form

CA-5 Form

CA 5a Form

CA-6 Form

CA-7 Form

CA-7A Form

CA-7b Form

CA 10 Form

CA 12 Form

CA-17 Form

CA 278 Form

CA 721 Form

CA722 Form

CA 1031 Form

CA 1074 Form

CA 1108 Form

CA 1122 Form

CA 2231 Form

CC-4 Form

CC-257 Form in WORD

CC-257 Form in EXCEL

CM-1093 Form

CM-1159 Form

CM-2907 Form

CM-2970 Form

CM-2970a Form

CM-623 Form

CM-623S Form

CM-787 Form

CM-893 Form

CM-908 Form

CM-910 Form

CM-911 Form

CM-911a Form

CM-912 Form

CM-913 Form

CM-918 Form

CM-929 Form

CM-933 Form

CM-933b Form

CM-936 Form

CM-936 Form

CM-957 Form

CM-970 Form

CM-970a Form

CM-972 Form

CM-981 Form

CM-988 Form

DOL RNO-1 Form

EEO-1 Form

EEOICP EE1 Form

EEOICP EE2 Form

EEOICP EE3 Form

EEOICP EE4 Form

EEOICP EE5 Form

ETA-9081 Form

ETA-750A Form

ETA-750B Form

ETA 790

ETA 9033

ETA 9033-A

ETA 9035 Form

ETA 9035CP Form

ETA 9081 Form

ETA 9089

ETA 9127

ETA 9141

ETA 9142

ETA 9142 A.1 and A.2

ETA 9142 B.1

LM-1 Form

LM 2 Form

LM3 Form

LM4 Form