Address Change Request for Injured Workers - (Spanish) Solicitud para cambio de dirección para trabajadores lesionados


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Title Address Change Request for Injured Workers - (Spanish) Solicitud para cambio de dirección para trabajadores lesionados
Description

Completed and signed by a State Fund injured worker to notify L&I of a change in address. All address changes must be submitted in writing and signed by the injured worker.

Document number F242-388-999
How to get this document
Keywords change of address, claim information, claims, disability, disabled, español, espanol, industrial insurance, time loss compensation, time-loss compensation, worker's compensation, workers compensation, workers' compensation
Alt Language(s) English
Valid dates 07/2011
Contact information Claims for Job Injuries
Websites Workers' Comp Claims

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