Coverage Agreement

Document Information
  How to complete a fillable form.
Title Coverage Agreement

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

Document number F212-044-000
How to get this document
Alt Language(s)
Valid dates 06/2006
Contact information
Websites Insurance for Business

End of main content, page footer follows.

Access Washington official state portal

© Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington.