| Document Information | ||
|---|---|---|
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| Title |
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| 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 | F242-107-999 | |
| Availability | Online only. See document above to download. |
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| Keywords | change of address, claim information, claims, disability pension benefits, disabled, espanol, industrial insurance, pension disability benefits, social security offset, sso, worker's compensation, workers compensation, workers' compensation | |
| Languages | Spanish , English | |
| Valid dates | 07-2011 | |
| Contact information | ||
| Web pages | Workers' Comp Claims | |
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