Forms and Publications

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Title Number / Language
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Actions at Law for Injury or Death - RCW 51.24  F249-031-000 (English)
 F249-031-999 (Spanish)
Application for Benefits - Injury Claims  F800-042-000 (English)
Assignment of Account or Time Deposit for Insurance - Bodily Injury - WA State Banks Only  F625-082-000 (English)
Chapter 51.24 RCW Actions at Law for Injury or Death - Spanish Capítulo 51.24 Acciones Legales por Lesiones o Fallecimiento  F242-138-999 (Spanish)
Crime Victims' Application for Benefits - Injury Claims  F800-042-999 (Spanish)
Notice to Employees - If a Job Injury Occurs  F207-037-909 (English/Spanish)
Notice to Employees -- If a Job Injury Occurs  F242-191-909 (English/Spanish)
Report of Accident (ROA) Workplace Injury, Accident or Occupational Disease  F242-130-000 (English)
Report of an Injury, Illness, or Close Call  F417-278-000 (English)
Self-Insurance Report of Occupational Injury or Disease (SIF-5)  F207-005-000 (English)





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