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72
![Form CA-7a "Time Analysis Form"](https://data.templateroller.com/pdf_docs_html/1731/17317/1731740/form-ca-7a-time-analysis-form.png "Form CA-7a "Time Analysis Form"")
Form CA-7a "Time Analysis Form"
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(4.3 / 5) 92 votes Size: 133 KB
2
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This form is supposed to be used when a federal worker claims reimbursement for more than one consecutive period of leave. The application can be submitted by federal workers during their compensation cases.
![Form CMS-1500 "Health Insurance Claim Form"](https://data.templateroller.com/pdf_docs_html/2049/20492/2049228/form-cms-1500-health-insurance-claim-form.png "Form CMS-1500 "Health Insurance Claim Form"")
Form CMS-1500 "Health Insurance Claim Form"
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(4.4 / 5) 28 votes Size: 1 MB
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Physicians and other healthcare providers and professionals may use this legal document to submit claims for medical services. Form CMS-1500 provides information about the patient and insured, their diagnosis, treatment, and insurance details.
![Form WH-4 "Nonimmigrant Worker Information Form"](https://data.templateroller.com/pdf_docs_html/1904/19043/1904337/form-wh-4-nonimmigrant-worker-information-form.png "Form WH-4 "Nonimmigrant Worker Information Form"")
![Form CA-5 "Claim for Compensation by Surviving Spouse and/or Children"](https://data.templateroller.com/pdf_docs_html/1899/18990/1899064/form-ca-5-claim-compensation-by-surviving-spouse-and-or-children.png "Form CA-5 "Claim for Compensation by Surviving Spouse and/or Children"")
Form CA-5 "Claim for Compensation by Surviving Spouse and/or Children"
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(4.3 / 5) 79 votes Size: 1 MB
5
pages
![Form EE-3 "Employment History for a Claim Under the Energy Employees Occupational Illness Compensation Program Act"](https://data.templateroller.com/pdf_docs_html/1729/17291/1729142/form-ee-3-employment-history-a-claim-under-the-energy-employees-occupational-illness-compensation-program-act.png "Form EE-3 "Employment History for a Claim Under the Energy Employees Occupational Illness Compensation Program Act"")
Form EE-3 "Employment History for a Claim Under the Energy Employees Occupational Illness Compensation Program Act"
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(4.3 / 5) 48 votes Size: 2 MB
3
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![Form CA-1 "Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation"](https://data.templateroller.com/pdf_docs_html/1704/17042/1704283/form-ca-1-federal-employee-s-notice-traumatic-injury-and-claim-continuation-pay-compensation.png "Form CA-1 "Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation"")
Form CA-1 "Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation"
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(4.4 / 5) 70 votes Size: 57 KB
4
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![Form WH-2 "Application for Special Industrial Homeworker's Certificate"](https://data.templateroller.com/pdf_docs_html/1904/19043/1904336/form-wh-2-application-special-industrial-homeworker-s-certificate.png "Form WH-2 "Application for Special Industrial Homeworker's Certificate"")
Form WH-2 "Application for Special Industrial Homeworker's Certificate"
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(4.4 / 5) 57 votes Size: 1 MB
2
pages
![Form CA-6 "Official Superior's Report of Employee's Death"](https://data.templateroller.com/pdf_docs_html/1731/17314/1731473/form-ca-6-official-superior-s-report-employee-s-death.png "Form CA-6 "Official Superior's Report of Employee's Death"")
Form CA-6 "Official Superior's Report of Employee's Death"
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(4.8 / 5) 44 votes Size: 27 KB
2
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![Form M-1 "Report for Multiple Employer Welfare Arrangements (Mewas) and Certain Entities Claiming Exception (Eces)", 2015](https://data.templateroller.com/pdf_docs_html/2049/20493/2049317/form-m-1-report-for-multiple-employer-welfare-arrangements-mewas-and-certain-entities-claiming-exception-eces.png "Form M-1 "Report for Multiple Employer Welfare Arrangements (Mewas) and Certain Entities Claiming Exception (Eces)", 2015")
Form M-1 "Report for Multiple Employer Welfare Arrangements (Mewas) and Certain Entities Claiming Exception (Eces)", 2015
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(4.8 / 5) 22 votes Size: 1 MB
83
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![Instructions for Form M-1 "Report for Multiple Employer Welfare Arrangements (Mewas) and Certain Entities Claiming Exception (Eces)"](https://data.templateroller.com/pdf_docs_html/2049/20493/2049318/instructions-for-form-m-1-report-for-multiple-employer-welfare-arrangements-mewas-and-certain-entities-claiming-exception-eces.png "Instructions for Form M-1 "Report for Multiple Employer Welfare Arrangements (Mewas) and Certain Entities Claiming Exception (Eces)"")
Instructions for Form M-1 "Report for Multiple Employer Welfare Arrangements (Mewas) and Certain Entities Claiming Exception (Eces)"
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(4.3 / 5) 19 votes Size: 139 KB
11
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![Form OWCP-17 "Rehabilitation Maintenance Certificate"](https://data.templateroller.com/pdf_docs_html/1899/18990/1899072/form-owcp-17-rehabilitation-maintenance-certificate.png "Form OWCP-17 "Rehabilitation Maintenance Certificate"")
![Form OWCP-17 "Rehabilitation Maintenance Certificate"](https://data.templateroller.com/pdf_docs_html/1731/17317/1731744/form-owcp-17-rehabilitation-maintenance-certificate.png "Form OWCP-17 "Rehabilitation Maintenance Certificate"")
![Form OWCP-44 "Rehabilitation Action Report"](https://data.templateroller.com/pdf_docs_html/1899/18990/1899071/form-owcp-44-rehabilitation-action-report.png "Form OWCP-44 "Rehabilitation Action Report"")
![Form CA-5B "Claim for Compensation by Parents, Brothers, Sisiters, Grandparents, or Grandchildren"](https://data.templateroller.com/pdf_docs_html/1741/17415/1741585/form-ca-5b-claim-for-compensation-by-parents-brothers-sisiters-grandparents-or-grandchildren.png "Form CA-5B "Claim for Compensation by Parents, Brothers, Sisiters, Grandparents, or Grandchildren"")
Form CA-5B "Claim for Compensation by Parents, Brothers, Sisiters, Grandparents, or Grandchildren"
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(4.3 / 5) 14 votes Size: 1 MB
5
pages
![Form WH-46 "Application for Certificate to Employ Homeworkers"](https://data.templateroller.com/pdf_docs_html/1904/19043/1904335/form-wh-46-application-certificate-to-employ-homeworkers.png "Form WH-46 "Application for Certificate to Employ Homeworkers"")
Form WH-46 "Application for Certificate to Employ Homeworkers"
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(4.3 / 5) 57 votes Size: 298 KB
3
pages
![Form LS-33 "Approval of Compromise of Third Person Cause of Action"](https://data.templateroller.com/pdf_docs_html/1733/17338/1733835/form-ls-33-approval-compromise-third-person-cause-action.png "Form LS-33 "Approval of Compromise of Third Person Cause of Action"")
Form LS-33 "Approval of Compromise of Third Person Cause of Action"
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(4.6 / 5) 27 votes Size: 65 KB
1
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![Form CA-7b "Leave Buy Back (Lbb) Worksheet/ Certification and Election"](https://data.templateroller.com/pdf_docs_html/1731/17317/1731741/form-ca-7b-leave-buy-back-lbb-worksheet-certification-and-election.png "Form CA-7b "Leave Buy Back (Lbb) Worksheet/ Certification and Election"")
Form CA-7b "Leave Buy Back (Lbb) Worksheet/ Certification and Election"
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(4.4 / 5) 63 votes Size: 48 KB
4
pages
![Form CM-911 "Miner's Claim for Benefits Under the Black Lung Benefits Act"](https://data.templateroller.com/pdf_docs_html/1899/18990/1899067/form-cm-911-miner-s-claim-benefits-under-the-black-lung-benefits-act.png "Form CM-911 "Miner's Claim for Benefits Under the Black Lung Benefits Act"")
Form CM-911 "Miner's Claim for Benefits Under the Black Lung Benefits Act"
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(4.5 / 5) 52 votes Size: 1 MB
4
pages
![Form CM-936 "Authorization for Release of Medical Information (Black Lung Benefits)"](https://data.templateroller.com/pdf_docs_html/1899/18990/1899063/form-cm-936-authorization-release-medical-information-black-lung-benefits.png "Form CM-936 "Authorization for Release of Medical Information (Black Lung Benefits)"")
Form CM-936 "Authorization for Release of Medical Information (Black Lung Benefits)"
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(4.8 / 5) 27 votes Size: 1 MB
2
pages
![Form CM-908 "Notice of Termination, Suspension, Reduction, or Increase in Benefit Payments"](https://data.templateroller.com/pdf_docs_html/1899/18990/1899069/form-cm-908-notice-termination-suspension-reduction-or-increase-in-benefit-payments.png "Form CM-908 "Notice of Termination, Suspension, Reduction, or Increase in Benefit Payments"")
Form CM-908 "Notice of Termination, Suspension, Reduction, or Increase in Benefit Payments"
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(4.7 / 5) 44 votes Size: 1 MB
2
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![Form CM-910 "Request to Be Selected as Payee"](https://data.templateroller.com/pdf_docs_html/1899/18990/1899074/form-cm-910-request-to-be-selected-as-payee.png "Form CM-910 "Request to Be Selected as Payee"")
![Form LS-208 "Notice of Payments"](https://data.templateroller.com/pdf_docs_html/1899/18990/1899070/form-ls-208-notice-payments.png "Form LS-208 "Notice of Payments"")
![Form CM-981 "Certification by School Official"](https://data.templateroller.com/pdf_docs_html/1741/17415/1741583/form-cm-981-certification-by-school-official.png "Form CM-981 "Certification by School Official"")
![Form WH-530 "Application for a Farm Labor Contractor or Farm Labor Contractor Employee"](https://data.templateroller.com/pdf_docs_html/1789/17891/1789175/form-wh-530-application-a-farm-labor-contractor-or-farm-labor-contractor-employee.png "Form WH-530 "Application for a Farm Labor Contractor or Farm Labor Contractor Employee"")
Form WH-530 "Application for a Farm Labor Contractor or Farm Labor Contractor Employee"
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(4.4 / 5) 21 votes Size: 6 MB
7
pages
![Form WH-515 "Doctor's Certificate"](https://data.templateroller.com/pdf_docs_html/1904/19043/1904347/form-wh-515-doctor-s-certificate.png "Form WH-515 "Doctor's Certificate"")
![Form LS-207 "Notice of Controversion of Right to Compensation"](https://data.templateroller.com/pdf_docs_html/1899/18990/1899068/form-ls-207-notice-controversion-right-to-compensation.png "Form LS-207 "Notice of Controversion of Right to Compensation"")
Form LS-207 "Notice of Controversion of Right to Compensation"
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(4.6 / 5) 64 votes Size: 115 KB
2
pages
![Form LS-801 "Waiver of Service by Registered or Certified Mail for Employers and/or Insurance Carriers"](https://data.templateroller.com/pdf_docs_html/1904/19043/1904333/form-ls-801-waiver-service-by-registered-or-certified-mail-employers-and-or-insurance-carriers.png "Form LS-801 "Waiver of Service by Registered or Certified Mail for Employers and/or Insurance Carriers"")
Form LS-801 "Waiver of Service by Registered or Certified Mail for Employers and/or Insurance Carriers"
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(4.8 / 5) 57 votes Size: 180 KB
2
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![Form LS-206 "Payment of Compensation Without Award"](https://data.templateroller.com/pdf_docs_html/1733/17338/1733837/form-ls-206-payment-compensation-without-award.png "Form LS-206 "Payment of Compensation Without Award"")
![Form LS-266 "Application for Continuation of Death Benefit for Student"](https://data.templateroller.com/pdf_docs_html/1741/17415/1741576/form-ls-266-application-for-continuation-of-death-benefit-for-student.png "Form LS-266 "Application for Continuation of Death Benefit for Student"")
Form LS-266 "Application for Continuation of Death Benefit for Student"
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(4.4 / 5) 15 votes Size: 1 MB
2
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![Form LS-513 "Report of Payments"](https://data.templateroller.com/pdf_docs_html/1733/17338/1733831/form-ls-513-report-payments.png "Form LS-513 "Report of Payments"")
![Form CM-972 "Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by the U.S. Department of Labor"](https://data.templateroller.com/pdf_docs_html/1741/17415/1741575/form-cm-972-application-for-approval-of-a-representative-s-fee-in-a-black-lung-claim-proceeding-conducted-by-the-u-s-department-of-labor.png "Form CM-972 "Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by the U.S. Department of Labor"")
Form CM-972 "Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by the U.S. Department of Labor"
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(4.6 / 5) 60 votes Size: 1 MB
2
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![Form SF-308 "Request for Wage Determination and Response to Request"](https://data.templateroller.com/pdf_docs_html/1733/17337/1733773/form-sf-308-request-wage-determination-and-response-to-request.png "Form SF-308 "Request for Wage Determination and Response to Request"")
Form SF-308 "Request for Wage Determination and Response to Request"
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(4.8 / 5) 93 votes Size: 1 MB
1
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![Form LS-204 "Attending Physician's Supplementary Report"](https://data.templateroller.com/pdf_docs_html/1732/17328/1732888/form-ls-204-attending-physician-s-supplementary-report.png "Form LS-204 "Attending Physician's Supplementary Report"")
Form LS-204 "Attending Physician's Supplementary Report"
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(4.7 / 5) 84 votes Size: 395 KB
2
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![Form LS-262 "Claim for Death Benefits"](https://data.templateroller.com/pdf_docs_html/1733/17331/1733143/form-ls-262-claim-death-benefits.png "Form LS-262 "Claim for Death Benefits"")
![Form LS-267 "Claimant's Statement"](https://data.templateroller.com/pdf_docs_html/1733/17338/1733828/form-ls-267-claimant-s-statement.png "Form LS-267 "Claimant's Statement"")
![Form LS-426 "Request for Earnings Information"](https://data.templateroller.com/pdf_docs_html/1899/18990/1899073/form-ls-426-request-earnings-information.png "Form LS-426 "Request for Earnings Information"")
![Form LS-271 "Application for Self-insurance"](https://data.templateroller.com/pdf_docs_html/1741/17415/1741582/form-ls-271-application-for-self-insurance.png "Form LS-271 "Application for Self-insurance"")
![Form WH-520 "Housing Occupancy Certificate - Migrant and Seasonal Agricultural Worker Protection Act"](https://data.templateroller.com/pdf_docs_html/1904/19043/1904351/form-wh-520-housing-occupancy-certificate-migrant-and-seasonal-agricultural-worker-protection-act.png "Form WH-520 "Housing Occupancy Certificate - Migrant and Seasonal Agricultural Worker Protection Act"")
Form WH-520 "Housing Occupancy Certificate - Migrant and Seasonal Agricultural Worker Protection Act"
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(4.7 / 5) 66 votes Size: 168 KB
1
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![Form WH-501 "Wage Statement"](https://data.templateroller.com/pdf_docs_html/1728/17286/1728677/form-wh-501-wage-statement.png "Form WH-501 "Wage Statement"")
![Form LS-265 "Certification of Funeral Expenses"](https://data.templateroller.com/pdf_docs_html/1741/17415/1741586/form-ls-265-certification-of-funeral-expenses.png "Form LS-265 "Certification of Funeral Expenses"")
