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

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, non mandatory, 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.