Workers' Compensation Filing Information

Document Information
  How to complete a fillable form.
Title Workers' Compensation Filing Information

Used by only self-insured employers to comply with WAC 296-15-400. The form provides information and instructions to employees of self-insured employers in case of an injury or development of an occupational disease.

Document number F207-155-000
How to get this document
Alt Language(s) Español
Valid dates 12/2012
Contact information Claims for Job Injuries , Self-Insurance
Websites Insurance for Business , Self-Insured Employers

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