Get a Form or Publication: Most requested forms
 
Search again:

Advanced Search

See also

Title Type Number
Affidavit of Experience

This affidavit is used to record the hours of a trainee's electrical experience with direct supervision under a Washington certified journeyman, master or specialty electrician.

Form F500-043-000
Alteration Fire Safety Pre-Inspection Checklist
Available in: Spanish

Checklist for homeowners on how to upgrade their pre-HUD homes to approach the HUD standards in the area of fire safety.

Form F622-011-000
Application for Contractor Registration

This is the form you would complete to register as a general contractor or specialty contractor. This is not in the warehouse. Please print off of the internet.

Form F625-001-000
Application for Electrical Contractors License

Application used to get an electrical contractors license

Form F500-018-000
Application for Electrician Examination

Application and instructions for a Washington State electrician's certificate examination.

Form F626-001-000
Certified Project Payroll

There are instructions in one PDF file, and a blank form that may be printed in the other PDF. The word document is saved in Microsoft 2003 format and is a fillable word form.

Form F700-065-000
Construction Lien Notice

This form is to be used by suppliers to notify homeowners that they have the ability to file a construction lien against their property if payment is not received.

Form F625-054-000
Electrical Education Course Application

Used to get approval of a course as an electrical continuing education class. This application must be received by L&I at least 30 days before the course is offered.

Form F500-068-000
Model Disclosure Statement Notice to Customer

This disclosure statement is given to the consumer (customer) from the contractor showing they are registered in the state of Washington. The consumer (customer) signs this form as acknowledgement of receipt.

Form F625-030-000
Parent / School Authorization for Employment of a Minor and Special Variance

For legal guardians and school officials to approve a minor employee to work according to terms listed by the employer. This is NOT a work permit. Employers must obtain a minor work permit endorsement on their Master Business License where they employ workers under 18. The Special Variance for 16- and 17-year-olds to work up to 28 hours during the school weeks, is on page two of Parent/School Authorization form.

Form F700-002-000
Payment of Wages - RCW 49.48.010 and 49.52.050

This is a copy of the law that pretains to the payment of wages to an employee when they stop working for an employer. The wages due to the employee for the pay period worked prior to leaving.

Form F700-064-000
Prevailing Wage Complaint and Instructions
Available in: Spanish

Ask L&I to conduct an investigation into a prevailing wage violation that affects one or more employees. See box 30 on the form to see what types of complaints are covered. This form used to be F700-027-000. The Spanish version F700-027-999 is still on the internet until this form is translated into Spanish. IMPORTANT The Worker Rights Complaint form is now F700-148-000

Form F700-146-000
Provider Account Application

For providers to apply for a provider account number with L&I. Includes the Form W-9 Request for Taxpayer ID Number and Certification (F248-036-000). 10-2009 version is internet only, not printed.

Form F248-011-000
Provider Account Application - Independent Medical Examiner (IME)

In order to do independent medical exams a provider must obtain a provider account number with L&I. This packet includes the application and agreement with instructions, IME Provider Exam sites form (F245-047-000) and Request for Taxpayer ID and Certification - Form W-9 (F248-036-000) (8 pages).

Form F245-046-000
Provider Accounts Change Form for Crime Victims Compensation

Providers use to inform L&I that they have changes to their account. Such as changes to their Tax ID address/name, business address, billing address, name, or termination of account. This also includes a W-9 form.

Form F800-089-000
Providers Request for Adjustment

Providers use this to report total overpayment, partial overpayment and/or underpayment by L&I. These forms will be accepted by L&I. They may not be accepted by all Medical Bill Processors due to lack of a barcode.

Form F245-183-000
Release of Lien by Contractor and Subcontractor(s) - Sample only

This is a sample of a release of lien by a contractor or a subcontractor.

Form F625-029-000
Request for Claim Information

Used by workers, workers' representatives, employers or employers' representatives to request claim information from L&I.

Form F101-010-111
Sample Job Offer Letter

Sample of a job offer letter from a business to an injured employee.

Form F252-035-000
Statement of Intent to Pay Prevailing Wages Public Works Contract SAMPLE ONLY

Sample copy of the form that Contractors and Sub-contractors file a Statement of Intent to Pay Prevailing Wages public works contract upon accepting work on a public works project. This PDF file will not print. Copies are in the warehouse, order by the pad (25 a pad).

Form F700-029-000
Travel Reimbursement Request
Available in: Spanish

Injured workers use this form to request reimbursement for travel expenses used to receive treatment, retraining and/or vocational services. These forms will be accepted by L&I. They may not be accepted by all Medical Bill Processors due to lack of a barcode.

Form F245-145-000
Worker's Compensaiton Employer's Quarterly Report for Industrial Insurance - SAMPLE ONLY

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.

Form F212-055-000
Your search for "Most requested forms" returned 22 documents.



Visit AccessWA, the WA State Gov Portal
© Washington State Dept. of Labor and Industries. Use of this site is subject to the laws of the state of Washington. Access Agreement | Privacy and security statement | Intended use/external content policy | Staff only link