Workers' Compensation Employer's Quarterly Report - SAMPLE ONLY
See also
| Document Information | ||
|---|---|---|
 Get help downloading & printing files.  How to complete a fillable form. |
||
| Title |
 Workers' Compensation Employer's Quarterly Report - SAMPLE ONLY (268 KB PDF)
|
|
| Description | You must fill out this form quarterly even if you had no workers. These forms are mailed out quarterly to all employers. For instructions on how to complete the Quarterly Report, please refer to F212-239-000 which is available on the internet. This file on the internet is a sample only. |
|
| Detail | ||
| Form number | F212-055-000 | |
| Availability | Not available in print |
|
| Keywords | insurance reporting, most requested forms, worker's compensation, workers compensation | |
| Languages | English | |
| Valid dates | 03-2010 | |
| Contact information | ||
| Web pages | Insurance for Business | |
We value your feedback!
Please take this survey to help improve the L&I website.
Take survey
(About 3 minutes)
© Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington.