Workers' Compensation Employer's Quarterly Report - SAMPLE ONLY

Workers'' Compensation Employer''s Quarterly Report - SAMPLE ONLY - (Forms/Publications)
Document Information
  Get help downloading & printing files.   How to complete a fillable form.
Title   Workers'' Compensation Employer''s Quarterly Report - SAMPLE ONLY (268 KB PDF)
Description

You must fill out this form quarterly even if you had no workers. These forms are mailed out quarterly to all employers. For instructions on how to complete the Quarterly Report, please refer to F212-239-000 which is available on the internet. This file on the internet is a sample only.

Detail
Form number F212-055-000
Availability
Not available in print
Keywords insurance reporting, worker's compensation, workers compensation
Languages English
Valid dates 03-2010
Contact information
Web pages 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.