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Request for Change of Status - Apprenticeship/Training Agreements and Training Agents


Formulario
F100-021-000
 
Request for Revision of Standards


Formulario
F100-030-000
 
Request for Revision of Committee


Formulario
F100-031-000
 
Request for Approval of Proposed Standards


Formulario
F100-049-000
 
Request for Cancellation of Program


Formulario
F100-303-000
 
Request for Recognition of Apprenticeship Committee


Formulario
F100-504-000
 
Request for Cancellation of New Apprenticeship Committee


Formulario
F100-510-000
 
Request for Public Records


Formulario
F101-009-000
 
Request for Claim Information


Formulario
F101-010-111
 
SIF-4 Self Insured Employer's Request for Denial of Claim


Formulario
F207-163-000
 
SIEDRS (Self-Insurance Electronic Data Reporting System) Data Change Request


Formulario
F207-197-000
 
Overpayment Reimbursement Fund Request Coversheet


Formulario
F207-212-000
 
Address Change Request for Pensioners


Formulario
F242-107-000

Otro(s) idioma(s):
Español
 
Address Change Request for Injured Workers


Formulario
F242-388-000

Otro(s) idioma(s):
Español
 
Preauthorization Request for Services for State Fund Workers' Compensation Patients


Formulario
F242-397-000
 
Worker Request for Union Dispatch Records


Formulario
F242-410-000

Otro(s) idioma(s):
Español
 
Travel Reimbursement Request


Formulario
F245-145-000

Otro(s) idioma(s):
Español
 
Provider's Request for Adjustment


Formulario
F245-183-000
 
Labor and Industries Prosthetic Device Request Form


Formulario
F245-340-000
 
Physical/Occupational/Massage Therapy Provider Hotline Service Authorization Request


Formulario
F245-417-000
 
Hearing Aid Repair/Durable Medical Equipment Provider Hotline Service Authorization Request


Formulario
F245-418-000
 
Preferred Drug Line Prescription Authorization Request


Formulario
F245-419-000
 
Medical Device Review Request


Formulario
F252-013-000
 
Content Manager Request Form


Formulario
F252-071-000
 
Chronic Opioid Request Form


Formulario
F252-091-000
 
Subacute Opioid Request Form


Formulario
F252-097-000
 
OJT Information Request and Recommendation form


Formulario
F280-032-000
 
Cholinesterase Monitoring Reimbursement Request


Formulario
F413-062-000
 
Request for Confidentiality


Formulario
F416-016-000
 
Agency Requested Inspection


Formulario
F500-025-000
 
Request for Duplicate or Replacement License or Certificate


Formulario
F500-032-000
 
Request for Change of Address


Formulario
F500-044-000
 
Electrical Telecommunication Principal Member Owner Update Request


Formulario
F500-124-000
 
Request for Letter of Good Standing


Formulario
F500-128-000
 
Board of Boiler Rules Interpretation and Revision Request Form


Formulario
F620-017-000
 
Boiler/Pressure Vessel Clearance Variance Request


Formulario
F620-041-000
 
Board of Boiler Rules Extension of Inspection Frequency Request Form


Formulario
F620-055-000
 
Chief Inspector Clarification and Interpretation Request Form


Formulario
F620-056-000
 
Board of Boiler Rules Washington State Specials Request Form


Formulario
F620-057-000
 
Extension Request


Formulario
F621-053-000
 
Owner Requested/Red Tag Decommission Form


Formulario
F621-063-000
 
Request for Duplicate Elevator Certificate


Formulario
F621-065-000
 
Request for Duplicate Elevator Mechanic License


Formulario
F621-099-000
 
Permit Refund Request


Formulario
F621-105-000
 
Plan Approval Request - Recreational Vehicles and Recreational Park Trailers


Formulario
F622-006-000
 
Plan Approval Request - Conversion Vendor / Medical Units


Formulario
F622-035-000
 
Homeowners Manufactured / Mobile Home Variance Request


Formulario
F622-054-000
 
Structural Inspection Request Questionnaire


Formulario
F622-075-000
 
Roof Affidavit and Structural Inspection Request


Formulario
F622-076-000
 
Manufactured Home Installer Certification Tag Transfer Request form


Formulario
F622-079-000
 
Plan Approval Request - Factory Built Structures and Commercial Coaches


Formulario
F623-006-000
 
Subscription Request for Construction Contractor and Electrical Basic - CD


Formulario
F625-051-000
 
Request for Archive Records - Contractor Registration


Formulario
F625-094-000
 
Contractor Registration Request for Duplicate License or Address Change  


Formulario
F625-108-000
 
Request for Duplicate or Replacement Certificate


Formulario
F627-014-000
 
Plumber Request for Change of Address


Formulario
F627-039-000
 
Request for Assistance in Obtaining Certified Payroll Records


Formulario
F700-141-000
 
Travel Reimbursement Request - Crime Victims


Formulario
F800-049-000
 
Request for Survivor Counseling Benefits / Solicitud para beneficios de apoyo para los sobrevivientes (English/español)


Formulario
F800-057-909
 
Crime Victims Provider's Request for Adjustment


Formulario
F800-064-000
 
Crime Victims Address Change Request


Formulario
F800-112-000
 
Crime Victims Compensation Subacute Opioid Request Form


Formulario
F800-119-000
 
Application for Apprenticeship


Formulario
F100-033-000
 
Access Authorization for External Access to Apprenticeship Registration and Tracking System (ARTS)


Formulario
F100-535-000
 
Workplace Posters: Required and Recommended


Publicación
F101-054-000
 
Payment Method Authorization


Formulario
F120-211-000

Otro(s) idioma(s):
Español
 
Self-Insurer Accident Report (SIF-2)


Formulario
F207-002-000
 
Self-Insurance Report of Occupational Injury or Disease (SIF-5)


Formulario
F207-005-000
 
Self Insurance Continuing Education Sponsor/Instructor Application for Course Approval


Formulario
F207-192-000
 
Self-Insurance Electronic Data Reporting System (SIEDRS) Enrollment Form


Formulario
F207-193-000
 
Your Independent Medical Exam: For Employees of Self-Insured Businesses


Publicación
F207-202-000

Otro(s) idioma(s):
Español
 
Application for out of State Supplemental Reporting


Formulario
F212-234-000
 
Application for Elective Coverage of Excluded Employments


Formulario
F213-112-000
 
Notice of Completion of Public Works Contract


Formulario
F215-038-000
 
Financial Statement Sole Proprietors and Individuals


Formulario
F215-039-000
 
Financial Statement Businesses


Formulario
F215-040-000
 
Independent Medical Exam Doctor's Estimate of Physical Capacities


Formulario
F242-387-000
 
Affidavit for Time Loss Compensation Benefits


Formulario
F242-395-000

Otro(s) idioma(s):
Español
 
Chemical Exposure Questionnaire Packet


Formulario
F242-409-000

Otro(s) idioma(s):
Español
 
Hearing Aid Replacement Form


Formulario
F242-414-000
 
Stay at Work Wage Reimbursement Application for Employers


Formulario
F243-001-000
 
Stay at Work Expense Reimbursement Application for Employers Tools, Clothing, Training.


Formulario
F243-003-000
 
Transfer of Care Card


Formulario
F245-037-000

Otro(s) idioma(s):
Español
 
Provider Account Application - Independent Medical Examiner (IME)


Formulario
F245-046-000
 
Frequently Asked Questions about Job Modifications


Publicación
F245-057-000
 
Statement for Pharmacy Services


Formulario
F245-100-000
 
Your Independent Medical Exam


Formulario
F245-224-000

Otro(s) idioma(s):
Español
 
Job Modification Assistance Application


Formulario
F245-346-000

Otro(s) idioma(s):
Español
 
Pre-Job Accommodation Assistance Application


Formulario
F245-350-000
 
Retrospective Rating Adjustment Protest


Formulario
F250-024-000
 
PT/OT Referral Form


Formulario
F252-099-000
 
Occupational Hearing Loss Questionnaire


Formulario
F262-016-000

Otro(s) idioma(s):
Español
 
Q&A: Stay of Abatement Date


Publicación
F417-235-000
 
Application to Establish an Account and Access to L&I's Electrical Permit & Inspection System (EPIS) with L&I's Miscellaneous Accounts


Formulario
F500-054-000
 
Electrical Program Contacts


Publicación
F500-114-000
 
Rental Boiler Operating Permit - Good at this Location Only


Formulario
F620-042-000
 
Pre-Inspection Checklist for Hot Water Heating or Hot Water Supply Boilers


Checklist
F620-050-000
 
Application to Utilize Contractor Deposit (CD) Account


Formulario
F621-094-000
 
Assigned Savings Account


Formulario
F625-008-000
 
Reassignment of Savings Account or Time Deposit - Construction Contractors


Formulario
F625-011-000
 
Contractor Financial Information


Formulario
F625-061-000
 
Affidavit to Release Public Records


Formulario
F625-066-000
 
Assignment of Account or Time Deposit for Insurance - Bodily Injury - WA State Banks Only


Formulario
F625-082-000
 
Assignment of Account or Time Deposit for Insurance - Property Damage - WA State Banks Only


Formulario
F625-083-000
 
Variance Application - For exceptions from specific rules governing employment of minors.


Formulario
F700-076-000
 
Variance Application - Employment Standards


Formulario
F700-089-000
 
Application for Farm Internship


Formulario
F700-158-000
 
Affidavit of Wages Paid EHB 2805 Addendum


Formulario
F700-164-000
 
Student Learner Variance Application


Formulario
F700-166-000
 
Application to Reopen Crime Victim Claim Due to Worsening of Condition


Formulario
F800-031-000

Otro(s) idioma(s):
Español
 
Crime Victims Compensation Program Initial Response and Assessment: Form II


Formulario
F800-081-000
 
Crime Victims Compensation Program Progress Note: Form III


Formulario
F800-082-000
 
Crime Victims Compensation Program Treatment Report: Form IV


Formulario
F800-083-000
 
Victim Verification Form


Formulario
F800-110-000

Otro(s) idioma(s):
Español
 
Your Independent Medical Exam (IME): Crime Victims Compensation Program


Publicación
F800-115-000
 





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