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Affidavit to Release Public Records

This form is to request L&I to release public records in the contractors registration section.



Form
F625-066-000


 
Autorización para proveer información de reclamos

Usado por el trabajador para designar a una persona(s) como representante(s) autorizado(s) del reclamo del trabajador.  Un representante autorizado puede obtener acceso a la información de reclamo.



Form
F101-010-999



Alt Language(s):
Inglés
 
Contractor Financial Information

Used by the contractor to request L&I to release assignment of account that they used instead of a surety bond.



Form
F625-061-000


 
Request for Archive Records - Contractor Registration

This form is to request L&I to release archive records in the contractors registration section.



Form
F625-094-000


 
Request for Claim Information

Used by workers, workers' representatives, employers or employers' representatives to request claim information from L&I.



Form
F101-010-111


 
Application for Group Membership & Authorization for Release of Insurance Data
Used by employers who want to join a retrospective rating group; also, to authorize Labor & Industries to release the employers' insurance data to the retrospective rating group they want to join.

Form
F250-016-000


 





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