Application for Elective Coverage - Sole Proprietor, Partners, For-Profit Corporate Officers, or Member/Managers of Limited Liability Company (LLC)

Application for Elective Coverage - Sole Proprietor, Partners, For-Profit Corporate Officers, or Member/Managers of Limited Liability Company (LLC) - (Forms/Publications)
Document Information
  Get help downloading & printing files.   How to complete a fillable form.
Title   Application for Elective Coverage - Sole Proprietor, Partners, For-Profit Corporate Officers, or Member/Managers of Limited Liability Company (LLC) (162 KB PDF)
Description

Used by employers to apply for workers' compensation coverage for non-mandatory employment. Shows a list of categories of employment that are not considered mandatory to have workers' compensation.

Detail
Form number F213-042-000
Availability
Online only. See document above to download.
Keywords exempt, industrial insurance, insurance reporting, member coverage, non mandatory, officer coverage, optional coverage, owner coverage, voluntary coverage, worker's compensation, workers compensation
Languages English
Valid dates 03-2013
Contact information Managing Injured Workers' Claims
Claims for Job Injuries
Related information
Documents

Cancellation of Elective Coverage - Sole Proprietors/Partner, Member of Limited Liability Company (LLC), Member of Limited Liability Partnership (LLP) or For-Profit Corporate Officers


Cancellation of Elective Coverage for Excluded Employments


Application for Elective Coverage - Sole Proprietor, Partners, For-Profit Corporate Officers, or Member/Managers of Limited Liability Company (LLC)


Application for Exclusion/Inclusion - Mandatory Coverage (Family Farm)


Web pages 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.