Class B Book Refund Request Form for the purpose of requesting a refund of Class B Books purchased prior to March 1, 2013.

This form is a coversheet used by Self-Insurance for overpayment reimbursement fund requests.

A form to request a refund for an electrical work permit, elevator permit, or factory-assembled structure alteration permit.

Used by employers to present L&I with a list of decisions they are protesting by adjustment period. The form requests all necessary elements needed for L&I to process a request for reconsideration.

Fact sheet: Provides information to employers interested in the Retrospective Rating Program who want to compare group vs. individual participation. Explains the differences in minimum premium amount, fees, services, refund potential, choice, and risk. Also includes contact information for enrolling.

Pamphlet: Provides information about L&I's Retrospective Rating Program. In Retro, employers can earn a partial refund of workers' compensation premiums if they reduce workplace injuries and lower associated claim costs.

Used by providers to request an adjustment to their bill if their entire bill was paid in error, or if a portion of the bill was overpaid or underpaid. Attach required reports and/or documentation to support the request.

Used to Refund Money to L&I to correct your account REFUND NOTIFICATION