Get a Form or Publication: apply

Your search for "apply" returned 58 documents.

Title Type Number
Application for Accreditation of Engineer to Approve Industrial Utilization Equipment

Used by an Engineer to apply for accreditation by L&I to approve unlisted equipment.

Form F500-101-000
Application for Elective Coverage - Sole Proprietor, Partners, For-Profit Corporate Officers, or Member/Managers of Limited Liability Company (LLC)

Used by employers to apply for workers' compensation coverage for non-mandatory employment. Shows a list of categories of employment that are not considered mandatory to have workers' compensation.

Form F213-042-000
Application for Insignia Conversion Vendor/Medical Units

Used to apply for an official insignia for conversion vendor or medical unit factory-assembled structures. See sample form for instructions about how to fill out the form correctly.

Form F623-021-000
Application to Reopen Claim due to Worsening Condition - Spanish Aplicación para Reabrir un Reclamo Debido al Empeoramiento de la Condición 
Also available in: English, English/Spanish

Spanish version. Used by injured workers and doctors to apply to reopen an industrial injury or occupational disease claim that has been closed for longer than 60 days.

Form F242-079-999
Application to Reopen Claim Due to Worsening Condition
Also available in: English/Spanish, Spanish

Used by injured workers and doctors to apply to reopen an industrial injury or occupational disease claim that has been closed for longer than 60 days. 12-2009 version is in the warehouse until stock is used up, then the new 12-2012 version will be printed.

Form F242-079-000
Applying for Your Washington Business License: A Step-by-Step Guide- Spanish Aplicando para su Licencia de Negocio en Washington: Una Guía Detallada
Also available in: English

Pamphlet: Concise, easy-to-read pamphlet that explains the steps to apply for a business license and what to do if you plan to employ workers. Includes how to apply to be a registered construction contractor.

Publication F101-079-999
Apprenticeships For Tribal Members

 

Brochure: Designed for tribal members, this brochure provides an overview of apprenticeship. Topics include the benefits of apprenticeship, career options, how to apply and contact information.

 

Publication F100-532-000
Chapter 296-56 WAC - Safety Standards - Longshore, Stevedore and Waterfront Related Operations

The rules included in this chapter apply to any and all waterfront operations for longshore, stevedore and waterfront  related operations, cargo handling, and related terminal operations and equipment under the jurisdiction of the  Department of  Labor and  Industries.

Manual F414-034-000
Complete Stay at Work Guide for Employers, The

Booklet: Explains Stay at Work, a financial incentive program that encourages Washington employers to find light-duty or transitional jobs for workers recovering from on-the-job injuries. Provides information on reimbursements, what is covered and how to apply. Detailed Q&A section included.

Publication F243-005-000
Contractor Electrical Work Permit Application

This application is used to apply for a valid electrical permit from L&I. 4 pages.

Form F500-093-000
Employment History Form
Also available in: Spanish

Used to provide your employment history for the past three years, including self-employment and volunteer work.

Please start with your most recent job and work backwards. Please list any gaps or interruptions in your work history.  If you were unemployed at any time, please explain why.  Did you apply for (or receive) unemployment benefits during the time period? If yes, what dates did you receive unemployment benefits?  Did you seek employment during the time period?  If no, why didn’t you seek employment?

Form F242-109-000
Non-Network Provider Application

Includes the F248-036-000 Statewide Payee Registration and W-9 form. For providers to complete that do not want to become a Labor and Industries network provider, or for a specialty that L&I is not accepting network applications for at this time. If you are applying to be a Labor and Industries network provider, please complete application process at www.ProviderNetwork.Lni.wa.gov

Form F248-011-000
Option 2 Vocational Benefits Training Enrollment Application and Verification
Also available in: English/Spanish

State fund workers who have selected Option 2 and closed their claim can use this form to apply for access to their Option 2 training funds. To seek reimbursement, use form F245-030-000 Statement for Retraining and Job Modification Services.

Form F280-024-000
Property Owner Electrical Work Permit Application

This application is used to apply for a valid electrical permit. 5 pages.

Form F500-094-000
Request for Preferred Workers Status

Used by vocational providers to apply for preferred worker status on behalf of an industrially injured worker.

Form F280-023-000
Stay at Work: A new program to help employers keep injured workers on the job--pays half the wage plus expenses (Programa permanezca en el trabajo - Un nuevo programa para ayudar a los empleadores a mantener a los trabajadores lesionados en el trabajo
Also available in: English

Pamphlet/booklet: Provides an overview Stay at Work, a financial incentive program that encourages Washington employers to find light-duty or transitional jobs for workers recovering from on-the-job injuries. Includes information on eligibility, how to apply, and where to get more information.

Publication F243-006-999
Stay at Work: A new program to help employers keep injured workers on the job--pays half the wage plus expenses
Also available in: Spanish

Pamphlet/booklet: Provides an overview Stay at Work, a financial incentive program that encourages Washington employers to find light-duty or transitional jobs for workers recovering from on-the-job injuries. Includes information on eligibility, how to apply, and where to get more information.

Publication F243-006-000
Submission of Provider Credentials for Interpretive Services

Used to apply as a interpretive service provider and to show what language(s) you hold credentials for. F248-011-000 Provider Application and Notice is added to this form.

Form F245-055-000
Upgrade from Specialty Contractor to General Contractor

Used to apply for an upgrade from Specialty Contractor to a General (01) Contractor.

Form F625-113-000
When a Loved One Dies at Work - Spanish (Cuando un ser querido fallece en el lugar de trabajo)
Also available in: English

Brochure: Provides information to loved ones of workers who died from a job-related injury or illness, including how to apply for survivor benefits. Explains the L&I fatality investigation and how family members can stay informed of the investigation's status.

Publication F417-240-999
A Parents' Guide to Apprenticeships

Booklet: Designed specifically for parents, this booklet provides an overview of apprenticeship. Topics include the benefits of apprenticeship, career options, requirements, how to apply and contact information.

Publication F100-530-000
Affidavit for Amusement Rides

Affidavit of experience to apply for cetification as a Amusement Ride Inspector.

Form F500-066-000
Agreement of Assumption and Guarantee of Workers' Compensation Liabilities - Application of Certification

Used by an employer to apply for self-insurance.

Form F207-040-000
Application for a Journeyman, Residential Specialty, Rec Plumbers or Med Gas Certificate

This form is used to apply for plumber examination, reciprocal and medical gas endorsement.

Form F627-008-000
Application for Amusement Ride or Air Supported Structure Operating Permit

To apply for a decal for an amusement ride or air supported structure.

Form F500-010-000
Application for Apprenticeship

EXAMPLE ONLY: Example of an application to apply for an apprenticeship. Registered Apprenticeship Programs use their own forms. NOT TO BE USED TO REQUEST PLUMBER or ELECTRICAL TRAINEE CARD.

Form F100-033-000
Application for Asbestos Contractor Certification

Contractors use this form to apply to be a certified asbestos contractor in Washington state.

Form F413-007-000
Application for Backflow Specialty Exam

This form is used to apply for the backflow specialty examination.

Form F627-035-000
Application for Backflow Trainee Certificate

This form is used to apply for a backflow trainee certificate.

Form F627-033-000
Application for Certificate of Competency as an Inspector of Pressure Retaining Items

To apply for a certificate of competency as an Inspector of Pressure Retaining items. You can only mail or fax this form to L&I. Emailed forms are not accepted. NOTE: Applications MUST be received no later than 30 days prior to the exam date. Incomplete applications WILL NOT be accepted.

Form F620-040-000
Application for Charter Boat Operators License

Use this form to apply for an operators license of a charter vessel.

Form F416-034-000
Application for Copies of Citation and Notice

Used by an employee to apply for copies of citation and notices issued to their employer.

Form F418-023-000
Application for Farm Labor Contractor License

Used to apply or renew a license.

Form F700-014-000
Application for Insignia for Commercial Coaches

Manufacturer uses this form to apply for an official insignia for commercial coaches that have a plan approval number.

Form F623-019-000
Application for Insignia for Factory Assembled Structures

Manufacturers uses this form to apply for an official insignia for a factory-built structure that has a plan approval number.

Form F623-014-000
Application for Master Electrician Certification Examination

Use this form to apply for the master electrician exam.

Form F500-088-000
Application for Permit to Operate Radio System in Designated Area

This form is used by the logging industry to apply for a permit to operate a radio signal system.

Form F416-087-000
Application for Plumber Trainee Certificate

This form is used to apply for a plumber trainee certificate.

Form F627-003-000
Application for Self-Insurance Certification

Used by employers to apply for self-insurance certification.

Form F207-001-000
Application for State Plan Insignia for Recreational Vehicles and Recreational Park Trailers

To apply for an insignia for a recreational vehicle.

Form F622-021-000
Applying for Your Washington Business License: A Step-by-Step Guide
Also available in: Spanish

Pamphlet: Concise, easy-to-read pamphlet that explains the steps to apply for a business license and what to do if you plan to employ workers. Includes how to apply to be a registered construction contractor.

Publication F101-079-000
Construction Elevator Installation Application and Inspection Data Report

Used by companies to apply for an Construction Elevator (Hoist) at a job site. One application per car and companies need to contact the Elevator Section for the appropriate installation and operating fee.

Form F621-001-000
Electrical Installation Variance Application

To apply for a variance which is an allowable deviation from specific requirements of a National Electrical Code section, or the WAC 296-46B where the proposed alternate methods will maintain equivalent safety.

Form F500-063-000
Elevator Continuing Education Course Application

This is used to apply for approval of elevator related continuing education courses.

Form F621-077-000
Elevator Installation Variance Application

Property owner or elevator company can apply for a variance to install an elevator. 4 pages.

Form F621-048-000
Forklift Safety Guide

Book: Provides general information on kinds of forklifts, principles of physics that apply to forklifts, training requirements for forklift operators, basic operator safety rules, dangers of carbon monoxide, and safety while servicing a forklift.

Publication F417-031-000
Help for Crime Victims/Ayuda para víctimas de crimen (English/Spanish)

Pamphlet/booklet: Answers questions about Washington State's Crime Victims Compensation Program, who may be eligible for benefits and how to apply.

Publication F800-006-909
Homeowners Manufactured / Mobile Home Variance Request

This variance request applies only to the installations performed by a previous owner and does not apply to any home during the warranty period.

Form F622-054-000
Insignia Continuation Sheet Recreational Vehicles and Park Trailers

Continuation sheet to apply for an insignia.

Form F622-021-111
L&I Chiropractic Consultant Application

This application is for doctors applying for second opinion examiner (consultant) status. Current consultants do not need to reapply.

Form F245-393-000
Option 2 Vocational Benefits Training Enrollment Application/Aplicación y verificación del registro(English/Spanish)
Also available in: English

State fund workers who have selected Option 2 and closed their claim can use this form to apply for access to their Option 2 training funds. To seek reimbursement, use form F245-030-000 Statement for Retraining and Job Modification Services.

Form F280-024-909
Physical Exam - Charter Boat Operators License

This form is used by applicants applying for a charter boat operators license to have completed by a physician for an operators license

Form F416-056-000
Provider Application and Notice for new firms

Complete this application and the StateWide Payee W-9 if you are applying for a firm Provider Number with L&I.

Form F252-088-000
Self Insurance Continuing Education Sponsor/Instructor Application for Course Approval

Used by sponsors or instructors of continuing education courses, when requesting the department assign credit to a course so that department-approved claims administrators who attend can earn credit toward recertification under the Self Insurance Continuing Education program.

Form F207-192-000
Self-Insurance Certification Questionnaire

Used by employers applying to become self-insured to describe their proposed workers' compensation program.

Form F207-176-000
Self-Insurance Continuing Education Application for Course Approval and Attendance

Used by Certified Claims Administrators to apply for continuing education credits for a course attended that has not been approved for credits.

Form F207-206-000
Variance Application - IND S&H

Use this form to apply for a variance for an allowed deviation from a specific safety or health standard when an employer substitutes measures which afford an equal degree of safety.

Form F414-021-000
When a Loved One Dies at Work
Also available in: Spanish

Brochure: Provides information to loved ones of workers who died from a job-related injury or illness, including how to apply for survivor benefits. Explains the L&I fatality investigation and how family members can stay informed of the investigation's status.

Publication F417-240-000

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