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Get DoL CA-7 2005-2024

Intermittent? Yes Leave without pay Leave buy back Other wage loss; specify type, such as downgrade, loss of Type: night differential, etc. a. b. c. No No Yes Yes No Go to Section 3 Go to Section 3, and Complete Form CA-7b Go to Section 3 If intermittent, complete Form CA-7a, Time Analysis Sheet Schedule Award (Go to Section 4) d. f. Telephone No./FAX No. ( ) ( ) Compensation is claimed for: You must report all earnings from employment (outside your federal job); include any employme.

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