Get a Form or Publication: access

Your search for "access" returned 14 documents.

Title Type Number
Access Authorization for External Access to Apprenticeship Registration and Tracking System (ARTS)

Form must be filled out to request access to Apprenticeship Registration and Tracking System (ARTS).

Form F100-535-000
Autorización para Proveer Información de Reclamos
Also available in: English

Used by the worker to designate a person(s) as an authorized representative for the worker's claim. An authorized representative can access claim information.

Form F101-010-999
Option 2 Vocational Benefits Training Enrollment Application and Verification
Also available in: English/Spanish

State fund workers who have selected Option 2 and closed their claim can use this form to apply for access to their Option 2 training funds. To seek reimbursement, use form F245-030-000 Statement for Retraining and Job Modification Services.

Form F280-024-000
Option 2 Vocational Benefits Training Enrollment Application/Aplicación y Verificación del Registro (English/Spanish)
Also available in: English

State fund workers who have selected Option 2 and closed their claim can use this form to apply for access to their Option 2 training funds. To seek reimbursement, use form F245-030-000 Statement for Retraining and Job Modification Services.

Form F280-024-909
Affidavit of Wages Paid - Public Works Contract and Instructions

This form is a fillable Word document that is used by a contractor, company or agency to show the wages paid to employees on a public works project. The best way to use this document is to bookmark this page as a “Favorite” in your web browser. Then each time when you want to use the document, access the online version of the form. This will ensure you are always utilizing the most recently published form. (We recommend you not download the document and save the form for future use because we may make changes to the form that your downloaded version will not contain.) You must file the Affidavit of Wages Paid form when you have completed your portion of a public works job/project. Addendum A is form number F700-161-000, Addendum C is form number F700-162-000, and the EHB 2805 (RCW 39.04.370) Addendum is form number F700-164-000.

Form F700-007-000
Application for Agent On-Line Insurance Entry Account

Application for Agent On-Line Insurance Entry Account

Form F625-110-000
Application to Access L&I's Electrical Permit and Inspection System (EPIS) from SecureAccess Washington and Utilize Contractor Deposit Account via the Internet

To establish a contractor deposit account by an electrical contactor or registered construction contractors who are legally required to purchase electrical work permits from L&I.

Form F500-055-000
APPLICATION TO ACCESS L&I’s ELECTRONIC PERMIT & INSPECTION SYSTEM (EPIS) FROM SECURE ACCESS WASHINGTON AND UTILIZE CONTRACTOR DEPOSIT ACCOUNT VIA THE INTERNET

Form F621-094-000
Application to Establish an Account and Access to L&I's Electrical Permit & Inspection System (EPIS) with L&I's Miscellaneous Accounts

To request access to L&I's EPIS - Miscellaneous Accounts

Form F500-054-000
Authorization to Release Claim Information
Also available in: Spanish

Used by the worker to designate a person(s) as an authorized representative for the worker's claim. An authorized representative can access claim information.

Form F101-010-000
Statement of Intent to Pay Prevailing Wages - Public Works Contract

This form is a fillable Word document that is used by a contractor, company or agency upon accepting work on a public works project. The best way to use this use this document is to bookmark this page as a “Favorite” in your web browser. Then each time when you want to use the document, access the online version of the form. This will ensure you are always utilizing the most recently published form. (We recommend you not download the document and save it for future use because we may make changes to the form that your downloaded version will not contain.) You should file this form immediately after the contract is awarded and before you begin work. Form number F700-160-000 is addendum A and F700-163-000 is addendum C.

Form F700-029-000
Supplemental Agreement Third Party Pharmacy Provider

This agreement is to define access, performance and legal requirements for third party pharmacy billers who submit bills to and receive payment from L&I on behalf of pharmacy providers. This agreement authorizes L&I to accept and remit monies due the Pharmacy using a third party pharmacy biller.

Form F249-021-000
Wage-and-Hour Questions Employers Often Ask

Fact sheet: Provides answers to questions related to pay requirements, deductions from pay, hiring a teen worker, employee uniforms and access to personnel file. Includes contact information if an employer needs assistance with a specific situation.

Publication F700-150-000
Workers' Compensation File Information Contract

This is an agreement between an individual and/or firm and L&I which authorizes access to L&I's computer database/application. (5 pages)

Form F212-197-000



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