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 422 State Forms found

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EMPLOYMENT HISTORY FORM

 F242-109-000 1-06

First Report of Injury - EDI ONLY

 Form IA-1 r 1-1-02

PROVIDER'S INITIAL REPORT

 F207-028-000 09-2020

Work Status Form

 F242-052-000 09-2021

Address Change Request for Injured Workers

 F242-388-000 07-2011

Address Change Request for Injured Workers (Spanish)

 F242-388-999 07-2011

Address Change Request for Pensioners

 F242-107-000 07-2011

Address Change Request for Pensioners (Spanish)

 F242-107-999 07-2011

Affidavit for Time Loss Compensation

 F242-395-000 01-2009

AGREEMENT OF ASSUMPTION AND GUARANTEE OF WORKERS' COMPENSATION LIABILITIES (Certified Self-Insurer)

 F207-040-001 11-00

Application for Inclusion on List of Eligible Attorneys

 F249-017-000 08-2016

APPLICATION FOR L.E.P. COMPENSATION MED

 F242-208-000 12-2004

APPLICATION FOR L.E.P. COMPENSATION MED (Spanish)

 F242-208-999 12-2004

APPLICATION FOR L.E.P. COMPENSATION VOC

 F242-209-000 12-2004

APPLICATION FOR L.E.P. COMPENSATION VOC (Spanish)

 F242-209-999 12-2004
Disclaimer: These forms may not be the most recent version. Washington may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on this site. Please check official sources.
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