Address Change Request for Pensioners

Address Change Request for Pensioners - (Forms/Publications)
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Title Address Change Request for Pensioners (A fillable form - 133 KB PDF)

Used by the pensioner to notify L&I of a new mailing address. L&I must receive this form by the first day of the month so your monthly payment is received in a timely manner.

Form number F242-107-000
Online only. See document above to download.
Keywords change of address, disability pension benefits, disabled, espanol, industrial insurance, pension disability benefits, social security offset, spanish, sso, worker's compensation, workers compensation, workers' compensation
Languages English , Spanish
Valid dates 07-2011
Contact information
Web pages Workers' Comp Claims

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