Coverage Agreement

Coverage Agreement - (Forms/Publications)
Document Information
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Title   Coverage Agreement (92 KB PDF)
Description

An agreement between a worker and employer which states the worker's employment is principally localized in Washington state or another state.

Detail
Form number F212-044-000
Availability
Online only. See document above to download.
Keywords employee, employment, industrial insurance, insurance coverage, worker's compensation, workers compensation, workers' compensation
Languages English
Valid dates 06-2006
Contact information Employer Services - 360-902-4817
Web pages Insurance for Business

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