Address Change Request for Pensioners

Document Information
  How to complete a fillable form.
Title Address Change Request for Pensioners

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.

Document number F242-107-000
How to get this document
Alt Language(s) Español
Valid dates 07/2011
Contact information
Websites Workers' Comp Claims

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