Address Change Request for Pensioners

Address Change Request for Pensioners - (Forms/Publications)
Document Information
  Get help downloading & printing files.   How to complete a fillable form.
Title Address Change Request for Pensioners (A fillable form - 133 KB PDF)
Description

Used by the pensioner to notify L&I of a new mailing address. L&I must receive this form by the first day of the month so your monthly payment is received in a timely manner.

Detail
Form number F242-107-000
Availability
Online only. See document above to download.
Keywords change of address, disability pension benefits, disabled, espanol, industrial insurance, pension disability benefits, social security offset, spanish, sso, worker's compensation, workers compensation, workers' compensation
Languages English , Spanish
Valid dates 07-2011
Contact information
Web pages Workers' Comp Claims

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.