Washington Workers Insured Out-of-State: Employer’s Supplemental Quarterly Report for Workers’ Compensation

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Title Washington Workers Insured Out-of-State: Employer’s Supplemental Quarterly Report for Workers’ Compensation (A fillable form - 309 KB PDF)
Description The purpose of 212-233-000 Supplemental reporting form is to allow employers to report out-of-state wages and hours as per the requirement in WAC 296-17-25203(8).
Detail
Form number F212-233-000
Availability
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Keywords out of state report, out-of-state, supplemental report
Languages English
Valid dates 11-2008
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