Special Escrow Account - Amendment Agreement

Special Escrow Account - Amendment Agreement - (Forms/Publications)
Document Information
  Get help downloading & printing files.   How to complete a fillable form.
Title Special Escrow Account - Amendment Agreement (A fillable form - 68 KB PDF)
Description Used by a self-insured employer to amend or change items on the surety document such as the amount of the escrow agreement used as collateral.
Form number F207-137-000
Online only. See document above to download.
Keywords agent, claims, industrial insurance, self insurance, self insurer, self-insurance, self-insurer, worker's compensation, workers compensation, workers' compensation
Languages English
Valid dates 10-2000
Contact information Self-Insurance
Web pages Self-Insured Employers
Insurance for Business

End of main content, page footer follows.

Access Washington official state portal

© Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington.