Form CM-623S Representative Payee Report

Form CM-623S Representative Payee Report

What Is Form CM-623S?

This is a legal form that was released by the U.S. Department of Labor - Division of Coal Mine Workers' Compensation on May 1, 2021 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2021;
  • The latest available edition released by the U.S. Department of Labor - Division of Coal Mine Workers' Compensation;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CM-623S by clicking the link below or browse more documents and templates provided by the U.S. Department of Labor - Division of Coal Mine Workers' Compensation.

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Download Form CM-623S Representative Payee Report

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