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What You Should Know About Hiring a Contractor, Remodeler, or Handyman

Pamphlet/booklet: Provides a checklist for consumers considering hiring a general or specialty construction contractor, reviews the permitting process, and suggests ways to avoid lien problems. Washington State law requires contractors to register with L&I.



Publicación
F625-084-000

Otro(s) idioma(s):
Español
 
Lo que Usted Debe Saber para Contratar a un Contratista, Remodelador o Empleado de Mantenimiento (Handyman)  

Hoja de información:  Proporciona una lista de verificación para los consumidores que están considerando contratar un contratista general o con especialidad, revisa el proceso de autorización y sugiere maneras para evitar problemas con gravámenes.  La ley estatal de Washington requiere que los contratistas de construcción se registren con L&I.



Publicación
F625-084-999

Otro(s) idioma(s):
Inglés
 
What to Do if You Want to File Suit Against Your Construction Contractor

Fact sheet: Provides consumers with general information about the process for filing suit, and describes L&I's limited role in serving Summons & Complaint papers.



Publicación
F625-088-000
 
Washington Contractor's License Bond Validation Rider

This rider is intended to be used in conjunction with a bond.



Formulario
F625-098-000
 
Washington Contractor's License Bond Name Change Rider

Used by the bond company to change the name of the contractor's business.



Formulario
F625-099-000
 
Washington Contractor's License Bond License Number Change Rider

Used by the bond company to change the contractor's business license number.



Formulario
F625-100-000
 
Washington Contractor's License Bond Date Change Rider

Used by the bond company to change the effective date of the contractor's bond.



Formulario
F625-101-000
 
Washington Contractor's License Bond Bond Amount Rider

Used by the bond company to amend the amount of the contractor's bond.



Formulario
F625-102-000
 
Washington Contractor's License Bond Entity Change Rider

Used by the bond company to show a change in the business structure of a contractor's business.



Formulario
F625-103-000
 
Washington Contractor's License Bond Address Change Rider

Used by the bond company to change the address of the contractor's business.



Formulario
F625-104-000
 
Renewal Application for Contractor Registration

Renewal Application for Contractor Registration



Formulario
F625-107-000
 
Contractor Registration Request for Duplicate License or Address Change  

This form may be faxed to the Contractor Registration office in Tumwater.



Formulario
F625-108-000
 
Application for Agent On-Line Insurance Entry Account

Application for Agent On-Line Insurance Entry Account



Formulario
F625-110-000
 
Upgrade from Specialty Contractor to General Contractor

Used to apply for an upgrade from Specialty Contractor to a General (01) Contractor.



Formulario
F625-113-000
 
Application for Electrician Examination

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



Formulario
F626-001-000
 
Application / Renewal for an Electrical Training Certificate

This the application for an Electrical Training Certificate or the renewal of. (This does NOT make you a registered apprentice).



Formulario
F626-048-000
 
Application for Plumber Trainee Certificate

This form is used to apply for a plumber trainee certificate.



Formulario
F627-003-000
 
Affidavit of Experience - Plumbers

This form is required to report plumber trainee's plumbing experience for credit towards journey level or specialty status.



Formulario
F627-004-000
 
Application for Plumber Examination, Reciprocal, Medical Gas Endorsement, or Temporary Permit

This form is used to apply for plumber examination, reciprocal and medical gas endorsement.



Formulario
F627-008-000
 
Request for Duplicate or Replacement Certificate

This form is used to request a duplicate or replacement certificate for a plumber or plumber trainee.



Formulario
F627-014-000
 
Plumber, Medical Gas, or Trainee Renewal

This form is used to renew a plumber certification, plumber trainee or medical gas installer certification.



Formulario
F627-019-000
 
Facts about State Certification for Plumbers
Fact sheet: Explains plumber classifications, certification requirements, including required exams, and the application and renewal processes, including continuing education requirements.

Publicación
F627-022-000
 
Facts about Medical Gas Piping Installer Endorsement
Fact sheet: Explains training requirements and the endorsement process for medical gas piping installers.

Publicación
F627-026-000
 
Plumbers Examination Dates and Locations

The 2014 and 2015 Plumber Examination Dates and Locations. A printed version of the 2014 Plumber Examination Dates and Locations is also available from the L&I Warehouse.



Formulario
F627-027-000
 
Application for Backflow Trainee Certificate

This form is used to apply for a backflow trainee certificate.



Formulario
F627-033-000
 
Application for Backflow Specialty Exam

This form is used to apply for the backflow specialty examination.



Formulario
F627-035-000
 
Plumber Continuing Education Course Application

This form is used by the course sponsor to submit continuing education courses for plumber certification.



Formulario
F627-037-000
 
Plumber Request for Change of Address
Plumber Request for Change of Address

Formulario
F627-039-000
 
Affidavit of Continuity Medical Gas Installation

Affidavit of Continuity



Formulario
F627-043-000
 
Hiring a Plumber? Hire Smart!

Worksheet: Provides advice and step-by-step hiring tips for homeowners planning a remodel, repair or addition to their home that involves plumbing. Tells homeowners how to verify that a construction contractor is registered and a plumber is certified with the state.



Publicación
F627-044-000
 
Parent / School Authorization for Employment of a Minor and Special Variance

For legal guardians and school officials to approve the hours and work activities for a minor employee to work according to terms listed by the employer. The Special Variance allows additional hours of work for 16- and 17-year-olds and is described on the form. All parties must sign to approve the hours of work for a minor regardless of the number of hours listed. 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.

For hiring youth only during non-school weeks, you may use form F700-168-000 Parent Authorization Summer Work  



Formulario
F700-002-000
 
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.



Formulario
F700-007-000
 
Record Keeping Provisions - Employment Standards

This form is for employers to use to keep records on every employee.



Formulario
F700-009-000
 
Operating Power Lawn and Yard-care Equipment: Safety for Teen Workers
Fact sheet: Overview of safety practices, plus information on what equipment employees under 18 can and cannot operate. Provides resources on requirements for hearing protection and PPE (personal protective equipment).

Publicación
F700-010-000
 
Application for Farm Labor Contractor License

Used to apply or renew a license.



Formulario
F700-014-000
 
Teens at Work: Facts for Employers, Parents and Teens

Pamphlet/booklet: Answers questions employers, parents and teens may have about employing teen workers (ages 14-17). Explains non-agriculture work rules, including the necessary permits, hours and work conditions. Provides links to other resources.



Publicación
F700-022-000

Otro(s) idioma(s):
Español
 
Adolescentes en el trabajo: información para empleadores, padres y adolescentes

Folleto: Responde a preguntas que los empleadores, padres y adolescentes podrían tener cuando contratan trabajadores adolescentes (edades 14-17). Explica las reglas de trabajo no agrícolas, incluyendo los permisos necesarios, horas y condiciones de trabajo. Proporciona enlaces para otros recursos.



Publicación
F700-022-999

Otro(s) idioma(s):
Inglés
 
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.



Formulario
F700-029-000
 
Washington State Prevailing Wage Law

Booklet: Contains the prevailing wage laws (RCWs) and rules (WACs) as well as plain language descriptions and contact information.



Publicación
F700-032-000
 
Agreement - Farm Labor Contractors and Workers

Employment wages and conditions agreement with Farm Labor Contractors and Workers



Formulario
F700-046-000

Otro(s) idioma(s):
Español
 
Acuerdo entre contratistas agrícolas y trabajadores

Formulario:  Acuerdo con los contratistas agrícolas y trabajadores sobre salarios de empleo y condiciones 



Formulario
F700-046-999

Otro(s) idioma(s):
Inglés
 
Minimum Wage Law Exemptions

Covers exemptions to Washington state minimum wage law.



Publicación
F700-051-000
 
Employer Rights - Wages Paid

Covers penalties for employer wage violations. Once stock runs out in warehouse, this form will be internet only.



Formulario
F700-058-000
 
Farm Labor Contractor Assignment of Account or Time Deposit

Farm Labor Contractor assignment of account or tme deposit for employee



Formulario
F700-060-000
 
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.



Formulario
F700-065-000
 
Farm Labor Contractors Bond

Notarized farm labor contractors bond coverage.



Formulario
F700-066-000
 
What Are Your Rights when You Work for a Farm Labor Contractor? (English/Spanish) / ¿Cúales son sus derechos cuando trabaja para un contratista de trabajadores agrícolas?

Fact sheet: Provides an overview of rights workers have when they are employed by a farm labor contractor. Several topics are covered, including regular wages, workplace safety, and help if injured on the job.



Publicación
F700-067-000
 
What Are Your Rights When You Work for a Farm Labor Contractor? / ¿Cúales son sus derechos cuando trabaja para un contratista de trabajadores agrícolas? (English/español)

Fact sheet: Explains workers' rights when they are employed by a farm labor contractor. Topics covered include workplace safety, rest and meal breaks, and help if injured on the job.

Hoja de información:  Explica los derechos de los trabajadores cuando están empleados por un contratista agrícola.  Los temas cubiertos incluyen seguridad en el lugar de trabajo, descanso y períodos de comida y ayuda si se lesionan en el trabajo.



Publicación
F700-067-909
 
Your Rights as a Worker in Washington State/ Sus derechos como trabajador en el estado de Washington (English/español)

Required poster: Reviews workers' rights under Washington's wage-and-hour laws. Topics include minimum wage, overtime, meal and rest breaks, pay periods, deductions, and employment of teens under age 18. Also reviews family leave provisions under federal and state law, and leave for spouses of deploying military personnel and victims of domestic violence. Note: Employers in both agricultural and non-agricultural industries in Washington State must display this poster where workers can see it.

Please order from L&I or print on 11" x 17" paper.

Get poster printing tips.

Cartel requerido: Da un resumen de los derechos de los trabajadores bajo las leyes de salario y horas de Washington.  Los temas incluyen el salario mínimo, horas extras, comida y períodos de descanso, deducciones y empleo de adolescentes menores de 18 años de edad.  También cubre las disposiciones de ausencia familiar bajo la ley federal y estatal y la ausencia para los cónyuges del personal militar y las víctimas de violencia doméstica.  Aviso:  Los empleadores tanto en la industria de la agricultura y otros sectores en el estado de Washington deben colocar este cartel donde los trabajadores puedan verlo.

Por favor solicítelo de L&I o imprímalo en papel de tamaño 11x17 pulgadas.

Obtenga consejos para imprimir carteles. 

 

 

 



Cartel
F700-074-909
 
Variance Application - For exceptions from specific rules governing employment of minors.

Employer uses this application for requesting a variance to employment regulations for minors.



Formulario
F700-076-000
 
Washington State OverTime Law

Covers compensation for employees in Washington State working overime.



Publicación
F700-079-000
 
Nonagricultural Employment of Minors Chapter 296-125 WAC

Nonagricultural Employment of Minors Chapter 296-125 WAC



Manual
F700-084-000
 
Estándares de Trabajo Agrícola Capítulo 296-131 del Código Administrativo de Washington (WAC, por su sigla en inglés)

Documento Legal: Estándares de trabajo agrícola - Capítulo 296-131 del Código Administrativo de Washington (WAC, por su sigla en inglés)



Manual
F700-085-999

Otro(s) idioma(s):
Inglés
 
Farm Labor Contractor Registration

Fact Sheet: Explains how to get a farm labor contractor license in order to operate legally as a farm labor contractor in Washington State.



Publicación
F700-088-000

Otro(s) idioma(s):
Español
 
Registro para un contratista de trabajadores agrícolas

Hoja de información:  Explica cómo obtener una licencia de contratista agrícola para poder operar legalmente como un contratista agrícola en el estado de Washington.



Publicación
F700-088-999

Otro(s) idioma(s):
Inglés
 
Variance Application - Employment Standards

Employer application request for a variance from employment standards for non minor employees.



Formulario
F700-089-000
 
Minimum Wage Law - Truck Drivers

Record keeping provisions and overtime for truck & bus drivers.



Publicación
F700-095-000
 
Young Workers in Agriculture / Trabajadores jóvenes en la agricultura (English/español)

Pamphlet/booklet: Answers many questions employers and minor workers have about employing minors. Covers agriculture work rules, including the necessary permits, hours and work conditions for workers 12-17 years of age.

Folleto:  Contesta muchas de las preguntas que tienen los empleadores y los trabajadores menores de edad sobre el empleo de menores.  Cubre las leyes de trabajo en la agricultura, incluyendo los permisos necesarios, horas y condiciones de trabajo para los trabajadores de 12-17 años de edad.



Publicación
F700-096-909
 
Washington State Deduction Laws

Deductions for current & terminated employees and employer liability for paying less than required.



Formulario
F700-097-000
 
Internal Revenue Service Tax Compliance Certification

Form to gain Internal Revenue Service Tax Compliance Certification for registered Farm Labor Contractors. Now includes IRS form 8821 Tax Information Authorization.



Formulario
F700-098-000
 
Department of Employment Security Tax Compliance Certification

Form to gain Department of Employment Security Tax Compliance Certification for registered Farm Labor Contractors.



Formulario
F700-099-000
 
Department of Revenue Tax Compliance Certification

Form to gain Department of Revenue Tax Compliance Certification for registered Farm Labor Contractors.



Formulario
F700-100-000
 
Your Daily Record of Hours Worked / Su registro de horas trabajadas (English/español)

Pamphlet/booklet: A pocket-sized bilingual booklet to encourage workers to keep track of their daily work hours and earnings.

Folleto: Un librito bilingüe de tamaño bolsillo para animar a los trabajadores a mantener un registro de sus horas de trabajo diarias y de sus ingresos.



Publicación
F700-105-909
 
Farm Labor Contractor Complaint Form

Used to file a complaint against a Farm Labor Contractor, landowner, employer, or other where a possible infraction is concerned.



Formulario
F700-109-000

Otro(s) idioma(s):
Español
 
Formulario de queja en contra de un contratista de trabajores agrícolas

Usado para presentar una queja contra un contratista agrícola,  hacendado, empleador u otro en lo que se refiere a una infracción.



Formulario
F700-109-999

Otro(s) idioma(s):
Inglés
 
Farm Labor Contractor Checklist

Farm Labor Contractor's Checklist to ensure compliance.



Formulario
F700-112-000

Otro(s) idioma(s):
Español
 
Lista de comprobacion para un contratista de trabajores agrícolas

Lista de comprobación para el contratista de trabajadores agrícola para asegurar el cumplimiento.



Formulario
F700-112-999

Otro(s) idioma(s):
Inglés
 
Employing Children Under Age 14 in Non-Agricultural Jobs

Fact sheet: Explains when employers can and cannot employ minors under age 14 in non-agricultural jobs. Details the process for obtaining court permission when hiring minors under 14 is allowed.



Publicación
F700-117-000
 
Employer Petition to The Court for Minor Work Permit Under Age 14

Petition to The Court for Minor Work Permit Under Age 14 by Employer.



Formulario
F700-118-000
 
Court Form Granting Permission for Employment of Minors

Form from Court Granting Permission for Employment of Minors to the employer.



Formulario
F700-119-000
 
Application for Special Certificate to Employ at A Subminimum Wage Rate

Employer Application for Special Certificate to Employ at A Subminimum Wage Rate.



Formulario
F700-120-000
 
Application for House to House Sales Sales Employer Registration Certificiate

Used by employers to register as employing minors who will be engaged in house-to-house sales, as required by WAC 296-125-024, with Labor and Industries.



Formulario
F700-121-000
 
Application for Special Certificate to Employ A Vocationally Handicapped Worker at at Subprevailing Wage Rate

Employer Application for Special Certificate to Employ A Vocationally Handicapped Worker at at Subprevailing



Formulario
F700-122-000
 
Summary of Agricultural Employment Regulations and Farm Contractor Requirements

This summary is on employment laws relating to the agricultural industry.



Publicación
F700-124-000
 
Agricultural Employer Worksheet

Used by agricultural employers to assist them in determining if they are following the state Agricultural Employment Standards and the Minimum Wage Act for their employees.



Formulario
F700-125-000
 
Interested Party Checklist for the Filing of Prevailing Wage Complaints

Checklist used for the filing of Prevailing Wage Complaints by "Interested parties" ONLY.



Formulario
F700-129-000
 
Seasonal Group Variance Application

Used for Exceptions from the Hours of Work for Minors for Seasonal work.  Complete the form, print it, sign it and fax or mail it to the address at the top of the form. Variance Application forms may be faxed to (360) 902-5300. If you would like the approved Variance Certificate faxed back to your business, please state so on your cover sheet.



Formulario
F700-135-000
 
Congratulations! You've been approved to hire minors
Card: Reminds employers of special work rules for employees under age 18. Lists key points and provides a Web address for where to find more detailed information. Sent to all employers who obtain a minor work permit endorsement on the master business license.

Publicación
F700-136-000
 
Safety Steps for Supervisors and Employees in Restaurants
Fact Sheet: A useful summary of the responsibilities both employers and employees share for a safe workplace. This can be shared with new employees during their initial orientation.

Publicación
F700-139-000
 
Restaurant Employee Safety Orientation Checklist
Fact Sheet: Download this checklist to help with the safety orientation of new restaurant employees.

Publicación
F700-140-000
 
Request for Assistance in Obtaining Certified Payroll Records

Used to request copies of Certified Payrolls for prevailing wage projects.



Formulario
F700-141-000
 
Hiring teens? / ¿Piensa contratar adolescentes? (English/español)

Fact sheet: Provides important information about hiring teens, including extra safety precautions, as well as legal requirements regarding minor work endorsement, hours and prohibited duties. Provides telephone, e-mail and Web contacts for more information.

Hoja de información:  Proporciona información importante sobre la contratación de adolescentes, incluyendo precauciones adicionales de seguridad, así como también los requisitos legales referentes al endoso de trabajo para menores, horas y tareas prohibidas.  Proporciona un teléfono, correo electrónico y contactos en la página Web para más información.

 



Publicación
F700-142-909
 
Affidavit of Wages Paid Addendum B List of Next Tier Subcontractors - Public Works Contract

Copies of the 05-2008 version will be available in the warehouse later in July.



Formulario
F700-143-000
 
Protected Leave Complaint

For leave from work complaints: Download and complete a Protected Leave Complaint form (F700-144-000)



Formulario
F700-144-000

Otro(s) idioma(s):
Español
 
Queja sobre el permiso de ausencia protegida

Para quejas de ausencia del trabajo: Descargue y complete un Formulario de queja sobre permiso de ausencia protegida (Número F700-144-999)



Formulario
F700-144-999

Otro(s) idioma(s):
Inglés
 
Youth in Construction / Adolescentes en construcción  (English/español)

Booklet/pamphlet: Explains the limits on work teens under age 18 can perform in the construction industry, discusses the importance of training and emphasizes safety. Includes a checklist of "do's" and "don'ts" for employers, plus other resources.

Pamfleto:  Explica los límites en los trabajos que los adolescentes menores de 18 años de edad pueden desempeñar en la industria de la construcción, discute la importancia de la capacitación y enfatiza la seguridad.  Incluye una lista para empleadores de lo que los adolescentes pueden y no pueden hacer además de otros recursos.



Publicación
F700-145-909
 
Prevailing Wage Complaint and Instructions

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.



Formulario
F700-146-000

Otro(s) idioma(s):
Español
 
Instrucciones para el registro de una queja sobre salario prevaleciente

Pídale a L&I que haga una investigación de un asunto relacionado con el salario prevaleciente que afecte a uno o más empleados.



Formulario
F700-146-999

Otro(s) idioma(s):
Inglés
 
Farm Labor Contractor Certified Payroll
Farm Labor Contractor Certified Payroll

Formulario
F700-147-000
 
Worker Rights Complaint Form

This is the Worker Rights Complaint Form. Both the 12-2011 and 10-2010 versions are valid.



Formulario
F700-148-000

Otro(s) idioma(s):
Español
 
Formulario de queja sobre los derechos laborales

Formulario: queja sobre los derechos laborales.  Las versiones de octubre de 2010 y de diciembre 2011 son válidas.



Formulario
F700-148-999

Otro(s) idioma(s):
Inglés
 
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.



Publicación
F700-150-000
 
Resumen de las Leyes de Salario Prevaleciente en lenguaje sencillo - entienda sus responsabilidades y derechos al hacer trabajos públicos

Hoja de información:  Documento con las medidas de 8.5 pulgadas x 11 pulgadas tamaño carta. Proporciona un resumen de las leyes y normas del salario prevaleciente en español.  Esta publicación está solamente disponible en español.  Para información similar en inglés, lea el folleto de la Ley de Salario Prevaleciente del estado de Washington.



Publicación
F700-152-999
 
What You Need to Know if You Don't Get Paid: A Worker's Guide to the Washington State Wage Payment Act / Lo que necesita saber si no recibe su pago: una guía para el trabajador de la ley del pago de salario del estado de Washington (English/español)

Fact sheet: Summarizes workers' rights and responsibilities regarding minimum wage, pay, work hours and overtime and explains how to file a wage complaint. Includes answers to several commonly asked questions.

Hoja de información:  Hace un resumen de los derechos y responsabilidades de los trabajadores referentes al salario mínimo, pago, horas trabajadas y horas extras y explica cómo presentar una queja de salario, incluye respuestas a varias preguntas frecuentes.



Publicación
F700-153-909
 
Avoid Liability for Your Farm Labor Contractor's Unpaid Debits / Evite su obligación por las deudas no pagadas de su contratista de trabajadores agrícolas (English/español)

Fact sheet: Explains how employers could be liable for unpaid workers' compensation premiums, unpaid wages, damages and civil penalties when hiring a farm labor contractor. Outlines ways to protect against potential liability.

Hoja de información:  Explica cómo los empleadores pueden ser responsables por las primas de compensación para los trabajadores, salarios no pagados, daños y multas civiles al contratar un contratista agrícola.  Indica maneras para protegerse contra una posible responsabilidad.

 



Publicación
F700-154-909
 
Application for Farm Internship

Application form: Small farm owners wishing to participate in the pilot small farm internship program must complete this form and submit it to the department. The information requested on the form is required to process an application for approval in order to issue a certificate of participation.



Formulario
F700-158-000
 
Statement of Intent to Pay Prevailing Wages Addendum A

Please use this addendum to list additional Crafts/Trades/Occupations when you need to add more Crafts/Trades/Occupations than the Statement of Intent to Pay Prevailing Wages form can accommodate. Addendum A is for form F700-029-000.



Formulario
F700-160-000
 
Affidavit of Wages Paid Addendum A Additional List of Crafts

Please use this addendum to list additional Crafts/Trades/Occupations when filing an Affidavit of Wages of Paid and you need to list more Crafts/Trades/Occupations than the Affidavit of Wages Paid form can accommodate. This is the addendum A to form F700-007-000.



Formulario
F700-161-000
 
Affidavit of Wages Paid Addendum C Additional Information

Please use this addendum to provide any additional information you want to communicate to L&I when you file an Affidavit of Wages of Paid. Addendum C is for form F700-007-000.



Formulario
F700-162-000
 
Statement of Intent to Pay Prevailing Wages Addendum C

Please use this addendum to provide any additional information you want to communicate to L&I when you file a Statement of Intent to Pay Prevailing Wages. Addendum C is for form F700-029-000.



Formulario
F700-163-000
 
Student Learner Variance Application

Employer uses this application form for requesting a variance to employment regulations for minors enrolled in a work-based learning placement. It can be used for individual or multiple minors for the same employer.



Formulario
F700-166-000
 
Employing teens under 18 in food service? - L&I’s fact sheet of permitted and prohibited work activities for youth ages 14 to 17 in food service

Fact sheet: Explains permitted and prohibited work activities for youth ages 14 to 17 in food service. Includes rules for driving, student-learner exemptions and work hours.



Publicación
F700-167-000
 
Your Daily Record of Hours and Units Worked - For Agricultural Workers / Su registro diario de horas y unidades trabajadas - para trabajadores agrícolas (English/español)

Booklet: A pocket-sized bilingual guide to encourage agricultural workers to keep track of their daily work hours, units and earnings.

Folleto: Una guía de bolsillo bilingüe para animar a los trabajadores agrícolas a mantener un registro de sus horas de trabajo diarias, unidades e ingresos.



Publicación
F700-169-909
 
Farm Labor Contractor Application/Renewal Packet

This is the packet you would complete to register as a farm labor contractor.



Formulario
F700-170-000
 
How To Calculate Your Wage in Agriculture

Fact/Information sheet: Shows piece rate workers how to calculate their wages to check if they are being paid minimum wage.



Publicación
F700-171-000

Otro(s) idioma(s):
Español
 
Cómo calcular su salario en agricultura

Hoja de información: Muestra a los trabajadores por contrato cómo calcular sus salarios y verificar si le están pagando salario mínimo.



Publicación
F700-171-999

Otro(s) idioma(s):
Inglés
 
Farm Internship Project Complaint Form

Complaint form for public to complete and submit



Formulario
F700-172-000
 
Help for Victims of Crime / Ayuda para víctimas de crimen (English/español)

Pamphlet/booklet: Answers questions about Washington State's Crime Victims Compensation Program, who may be eligible for benefits and how to apply.

Folleto: Responde preguntas sobre el Programa de Compensación para Víctimas de Crimen del estado de  Washington, quienes podrían tener derecho a recibir beneficios y cómo pueden aplicar. 

 



Publicación
F800-006-909
 
Statement for Crime Victims Mental Health Services

Used by the Crime Victims Compensation Program providers for reimbursement of Mental Health Services.



Formulario
F800-025-000
 
Application to Reopen Crime Victim Claim Due to Worsening of Condition

Benefits are limited to $50,000 per claim. if your claim has met or exceeded this cap, your reopening application will be denied and we will be unable to pay any further benefits. Used by victims of crime and medical or mental health providers to request a claim be reopened.



Formulario
F800-031-000

Otro(s) idioma(s):
Español
 
Solicitud para reabrir un reclamo debido al empeoramiento de la condición

Los beneficios están limitados a $50,000 por reclamo. Si su reclamo ha llegado o excedido  este límite, su solicitud de reapertura será negada y no podremos pagar beneficios futuros.  Usado por las víctimas de crimen y proveedores médicos o de salud mental para solicitar la reapertura de un reclamo.



Formulario
F800-031-999

Otro(s) idioma(s):
Inglés
 
Help for Crime Victims (large poster)

Poster (11" X 17"): Highlights the Crime Victims Compensation Program and provides contact information. Intended for display in health-care, criminal-justice and social-service organizations. Can be downloaded and printed, or ordered from L&I. Smaller version is also available (8.5" X 11"). Get 11" X 17" poster printing tips.



Cartel
F800-041-000

Otro(s) idioma(s):
Español
 
Ayuda para víctimas de crimen (cartel grande)

Cartel:  Documento con las medidas 11 X 17 pulgadas. Resalta el Programa de Compensación para Víctimas de Crimen y proporciona información para comunicarse con el programa. La intención es ponerlo a la vista en clínicas, organizaciones judiciales y de servicios sociales. Puede descargarse e imprimirse o solicitarse de L&I.  Hay una versión disponible más pequeña (8.5 X 11 pulgadas).



Cartel
F800-041-999

Otro(s) idioma(s):
Inglés
 
Application for Benefits - Crime Victims

Used by victims of a crime in Washington State to receive benefits for time lost from work, loss of financial support, medical or mental health treatment. The Spanish version of the instructions are online as F800-042-999.



Formulario
F800-042-000

Otro(s) idioma(s):
Español
 
Instrucciones para: Solicitud para Beneficios para Víctimas de Crimen

Instrucciones en español para completar el formulario F800-042-000, Solicitud para beneficios para víctimas de crimen.  El formulario es utilizado por víctimas de crimen en el estado de Washington para recibir beneficios de tiempo perdido del trabajo, pérdida de apoyo económico, tratamiento médico y de salud mental.  Esta versión del 10 de diciembre está en Internet solamente.



Formulario
F800-042-999

Otro(s) idioma(s):
Inglés
 
Travel Reimbursement Request - Crime Victims

If you are considered a victim of crime, use this form to track your travel expenses for medical, retraining or vocational services or for an independent medical exam. You should have approval from your claim manager before you travel.



Formulario
F800-049-000
 
Master Level Counselor Provider Account Application for Crime Victims

Master Level Counselor Provider Account Application for Crime Victims



Formulario
F800-053-000
 
Request for Survivor Counseling Benefits / Solicitud para beneficios de apoyo para los sobrevivientes (English/español)  

Used by immediate family members of homicide victims to request mental health counseling.

Utilizado por miembros de la familia inmediatos de víctimas de homicidio para solicitar asesoría de salud mental.



Formulario
F800-057-909
 
Know What to Expect: How Recoveries and Settlements May Impact Your Crime Victim Claim

Pamphlet and form: Explains third-party liability, recoveries and settlements. A crime victim or the Crime Victims Compensation Program may pursue monetary restitution from someone who caused or contributed to a crime victim's injury. Explains the purpose of the form and why individuals who file a crime victims claim are required to complete it.



Publicación
F800-074-000
 
Statement for Crime Victim Miscellaneous Services

Used by the provider or supplier for reimbursement of the following services - dental, glasses, home health, nursing home serivces, medical equipment, prosthetics-orthotics, transportation, vocational, retraining and other.



Formulario
F800-076-000
 
Crime Victims Compensation Program Initial Response and Assessment: Form I
Used by the clinical provider to get approval to see a victim for six sessions or less. If more than six sessions, please complete Form II (F800-081-000).

Formulario
F800-080-000
 
Crime Victims Compensation Program Initial Response and Assessment: Form II

Used by the clinical provider to request authorization to provide more than six sessions. This form must be submitted by the sixth session. (6 pages)



Formulario
F800-081-000
 
Crime Victim Compensation Program Sexual Assault Exam Report

A form used by physicians, hospitals and clinics to provide information and reporting to the Crime Victims Compensation Program.



Formulario
F800-098-000
 
Billing Guidelines for Sexual Assault Examinations: Crime Victims Compensation Program

Provides information health-care providers need to bill the Crime Victims Compensation Program for medical services.



Manual
F800-100-000
 
Helping Providers Understand the Crime Victims Compensation Program
Fact sheet: Answers questions doctors and mental health counselors may have about the Crime Victims Compensation Program and billing for services. Also suggests steps these providers can take to speed up reimbursement.

Publicación
F800-102-000
 
Help for Crime Victims (small poster)

Poster (8.5" X 11"): Highlights the Crime Victims Compensation Program and provides contact information. Intended for display in health-care, criminal-justice, and social-service organizations. Can be downloaded and printed, or ordered from L&I. Larger version is also available (11" X 17").



Cartel
F800-104-000

Otro(s) idioma(s):
Español
 
Mental Health Fee Schedule and Billing Guidelines

Manual: This manual is for providers who bill the Crime Victims Compensation Program for mental health services for crime victims.



Manual
F800-105-000
 
Formulario de verificación de empleo

Para ser utilizado por las víctimas de crimen que están solicitando compensación de reemplazo de salario.



Formulario
F800-110-999

Otro(s) idioma(s):
Inglés
 
Your Independent Medical Exam (IME): Crime Victims Compensation Program
Fact Sheet: Provides answers to commonly asked questions about independent medical exams (IMEs) and contact information. Includes a form for requesting travel-related reimbursement for attending an IME.

Publicación
F800-115-000
 
Crime Victims Direct Entry Billing Manual
Instructions for completing a Direct Entry bill to submit to the Crime Victims Compensation Program. Direct entry allows you to submit or adjust bills using a free online billing form through Provider Express Billing (PEB).

Manual
F800-118-000
 
Ten Safe Handling Hints for Knives
Shows ten tips on handling a knife safely. Get poster printing tips.

Cartel
FSP0-903-000
 
Preventing Slips and Falls
Information on how to prevent slips and falls with your footwear, housekeeping and also some general awareness tips. Get poster printing tips.

Cartel
FSP0-904-000
 
Stay Clear of Suspended Loads
Pictures a guy under a suspended wooden carton. Get poster printing tips.

Cartel
FSP0-908-000
 
Standard Hand Signals for Cranes

Poster: Displays proper hand signals for directing crawler, locomotive and truck crane operators. Please order from L&I or print on 11" X 17" paper.



Cartel
FSP0-910-000
 
Poster - An Unprotected Trench is an Early Grave

Poster: Trench safety information for employers. Features tips to prevent cave-ins, and proper inspection proceedures. Get poster printing tips.



Cartel
FSP0-912-000
 
The Best Accident Insurance - To observe all safety regulations
Picture of a guy with Saftey Policy and Rules in his hand. Get poster printing tips.

Cartel
FSP0-915-000
 
Four Steps to Proper Lifting
Pictures of a person lifting a large box correctly along with tips on how to correctly lift a large item safely. Get poster printing tips.

Cartel
FSP0-918-000
 
Robos y clientes abusivos: consejos para prevenir lesiones

Consejos sobre cómo manejar el dinero en efectivo y cómo tener un restaurante o un entorno minorista más seguro.  Obtenga información sobre cómo imprimir carteles.



Cartel
FSP0-919-999

Otro(s) idioma(s):
Inglés
 
Caution: Hard Hat Area / Precaución: obligatorio usar un casco (English/español)

Picture of hard hats. Get poster printing tips.

Fotografía de cascos.  Obtenga información sobre cómo imprimir carteles.



Cartel
FSP0-928-999

Otro(s) idioma(s):
Inglés
 
Always Wear Eye Protection
Picture of a large eye with some content on when to use eye protection. Get poster printing tips.

Cartel
FSP0-940-000

Otro(s) idioma(s):
Español
 
Siempre use protección para los ojos (English/español)

Fotografía de un ojo grande con contenido sobre cuando debe usar protección de los ojos. Obtenga información sobre cómo imprimir carteles.



Cartel
FSP0-940-999

Otro(s) idioma(s):
Inglés
 
Always Wear Eye Protection

Sticker: 7.25 inches X 4.25 inches.



Calcomanía
FSP0-941-000
 
Ladder Safety
Picture of a ladder with safety tips on the rungs. Get poster printing tips.

Cartel
FSP0-951-000
 
Sticker - Danger! Minimum Clearance - Logging

Sticker size = 8.25 x 6.



Calcomanía
FSP0-972-000
 
Danger! Minimum Clearance for Counter Balance - Construction

Sticker: 30 inches long.



Calcomanía
FSP0-974-000
 
Safe Ways - Fork Lift Safety
Safety tips on using a fork lift. Get poster printing tips.

Cartel
FSP0-978-000
 
Vocational Closing Report Routing Sheet

Routing slip that accompanies the Vocational Services Closing Cover Sheet (F252-028-000) which is used to close vocational services to an injured worker.



Formulario
F252-027-000
 
Grinding Wheel - Prevent Accidents

Sticker size 4"x3"



Calcomanía
FSP1-000-000
 
Vocational Services Closing Cover Sheet

Used to close vocational services of an injured worker. This form is attached to Vocational Closing Report Routing Sheets F280-013-000, F280-014-000 or F252-027-000.



Formulario
F252-028-000
 
Report All Injuries Promptly
Large words: Report All Injuries Promptly. Get poster printing tips.

Cartel
FSP1-004-000

Otro(s) idioma(s):
Español
 
Assessment Closing Report

Used by only private sector vocational rehabilitation providers to document vocational assessment to determine if a worker is employable based upon transferable skills.



Formulario
F252-029-000
 
Self-Insurance Vocational Reporting Form

Used by self-insured employers and their representatives to report to L&I an injured worker's eligibility for vocational services or ability to work. This replaces F207-121-000 Employability Assessment Report (EAR).



Formulario
F207-190-000
 
Report All Injuries Promptly / Reporte todas las lesiones inmediatamente (English / español)

Large words: Report All Injuries Promptly. Get poster printing tips.

Palabras en tamaño grande: Reporte todas las lesiones inmediatamente.  Obtenga información sobre cómo imprimir carteles.



Cartel
FSP1-004-999

Otro(s) idioma(s):
Inglés
 
Housing and Board Cost Encumbrance
To record the costs for housing and board. For use only with plans approved after 1/1/2008.

Formulario
F245-372-000
 
Training Plan Cost Encumbrance

To record the training costs. For use only with plans approved after 1/1/2008.



Formulario
F245-374-000
 
Well...My Daddy Wears 'Em
Little boy wearing his daddy's hard hat, eye protection, gloves and boots. Get poster printing tips.

Cartel
FSP1-010-000
 
Transportation Cost Encumbrance

To record the costs for transportation. For use only with plans approved after 1/1/2008.



Formulario
F245-375-000
 
Danger, Workers Above / Peligro - Trabajadores en el nivel superior (English/español)

Picture of workers on a high rise. Get poster printing tips.

Fotografía: Trabajadores en una superficie alta.  Obtenga instrucciones sobre cómo imprimir los carteles.



Cartel
FSP1-012-999

Otro(s) idioma(s):
Inglés
 
Plan Time Encumbrance
To record the work plan time. For use only with plans approved after 1/1/2008.

Formulario
F245-376-000
 
Plan Development: What Are My Rights & Responsibilities?
Booklet: Explains the basics of the plan development phase of vocational services to injured workers. L&I send this booklet to injured workers when they are referred for plan development services. The assigned vocational rehabilitation counselor is required to review this booklet with the worker at their initial face-to-face meeting.

Publicación
F280-018-000

Otro(s) idioma(s):
Español
 
Danger, Construction Area Authorized Personnel Only
Large words: Danger, Construction Area Authorized Personnel Only. Get poster printing tips.

Cartel
FSP1-013-000

Otro(s) idioma(s):
Español
 
Plan Development Quality Assurance Review Form

For use internally by L&I Vocational Service Specialists (VSSs) to determine if all required components are included in the submitted plan. Can be used by VRCs as a tool. DO NOT SUBMIT TO L&I.



Formulario
F280-007-000
 
Assessment Eligible Quality Assurance Review Form

For use internally by L&I Vocational Service Specialists (VSSs) to determine if all required components are included in the submitted assessment.  Can be used by VRCs as a tool.  DO NOT SUBMIT TO L&I.



Formulario
F280-008-000
 
Peligro - área en construcción - solamente personas authorizadas

En letras grandes: Peligro - área en construcción -  solamente personas autorizadas. Obtenga instrucciones sobre cómo imprimir los carteles.



Cartel
FSP1-013-999

Otro(s) idioma(s):
Inglés
 
Plan Development Recommending Plan Approval Routing Sheet
Routing slip that accompanies the Vocational Services Closing Cover Sheet (F252-028-000) which is used to close vocational services to an injured worker only if you are recommending Plan Approval. For all other closing reports, use Vocational Closing Report Routing Sheet (F252-027-000).

Formulario
F280-013-000
 
Accountability Agreement

This document provides the facts necessary to make an informed decision regarding vocational retraining benefits and explains the responsibilities you and your vocational counselor (VRC) have. For OJT retraining plans, please refer to form F280-029-000.



Formulario
F280-016-000

Otro(s) idioma(s):
Español
 
Danger / PELIGRO (English/español)

Large lettering: DANGER. Get poster printing tips.

Cartel: En letras grandes: PELIGRO. Obtenga instrucciones sobre cómo imprimir los carteles.



Cartel
FSP1-030-999

Otro(s) idioma(s):
Inglés
 
Assessing Your Ability to Work: Your Rights and Responsibilities
Booklet: Explains the basics of the assessment phase of vocational services to injured workers. L&I sends this booklet to injured workers when they are referred for assessment services.

Publicación
F280-017-000

Otro(s) idioma(s):
Español
 
Walk, Don't Run
Timeless reminder to walk, don't run, showing a banana peel. Get poster printing tips.

Cartel
FSP1-051-000
 
Carrying Out Your Vocational Plan: Your Rights and Responsibilities During Plan Implementation
Booklet: Explains the basics of the plan implementation phase of vocational services to injured workers. L&I sends this booklet to injured workers once the vocational plan they submitted is approved. Information about continuing with the vocational plan or selecting Option 2 to decline retraining is included.

Publicación
F280-019-000

Otro(s) idioma(s):
Español
 
Know Your Lockout Tagout Safety Procedures
Poster: Visual reminder you can print for posting in appropriate workplaces. Two options available for download and/or printing.

Cartel
FSP1-063-000
 
Evaluando su capacidad para trabajar: sus derechos y responsabilidades, servicios de rehabilitación vocacional

Folleto: Explica lo básico de la etapa de evaluación de los servicios vocacionales para los trabajadores lesionados. L&I le envia este folleto a los trabajadores lesionados cuando son referidos para servicios de evaluación.



Publicación
F280-017-999

Otro(s) idioma(s):
Inglés
 
Plan de desarrollo: ¿Cuáles son mis derechos y responsabilidades? Servicios de rehabilitación vocacional

Folleto: Explica lo básico de la etapa del plan de desarrollo de servicios vocacionales para trabajadores lesionados.  L&I envia este folleto a los trabajadores lesionados cuando son referidos para servicios del plan de desarrollo.  Se requiere que el consejero de rehabilitación vocacional asignado revise este folleto con el trabajador durante la reunión inicial en persona. 



Publicación
F280-018-999

Otro(s) idioma(s):
Inglés
 
Master Business Application

Link is to the Master Business License online form: Required for employers who hire minors and is obtained by completing the Master Business Application. Also available from L&I warehouse.



Formulario
BLSF-700-028
 
Llevando a cabo su plan vocacional: sus derechos y responsabilidades durante el plan de implementación, Servicios de rehabilitación vocacional

Folleto: Explica lo básico de la etapa del plan de implementación de servicios vocacionales para trabajadores lesionados. L&I envia este folleto a los trabajadores lesionados cuando son referidos para servicios del plan de desarrollo. Se requiere que el consejero de rehabilitación vocacional asignado revise este folleto con el trabajador durante la reunión inicial en persona. 



Publicación
F280-019-999

Otro(s) idioma(s):
Inglés
 
Apprentice Work Progress Record

Worksheets used to record the number of hours worked and Related Supplemental Instruction hours during a registered apprenticeship on a monthly basis. If used, a copy is usually given to the program monthly.



Formulario
F100-002-000
 
Option 2 Vocational Benefits Training Enrollment Application and Verification

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.



Formulario
F280-024-000

Otro(s) idioma(s):
Inglés/Español
 
Program Equal Employment Opportunity Activity Documentation

Used to record individual equal employment opportunity activities conducted by Apprenticeship Programs.



Formulario
F100-012-000
 
Option 2 Vocational Benefits Training Enrollment Application/Solicitud y verificación del registro para capacitación de beneficios vocacionales opción 2 (English/español)

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.

Los trabajadores bajo el Fondo estatal que han escogido la Opción 2 y que cerraron su reclamo pueden utilizar este formulario para solicitar acceso de los fondos de capacitación de la Opción 2.  Para solicitar un reembolso, utilice el formulario F245-030-999 Declaración de servicios de capacitación y servicios de modificación de trabajo.



Formulario
F280-024-909

Otro(s) idioma(s):
Inglés
 
On-the-Job Training Agreement Card

This card is used by an OJT Apprenticeship program ONLY. To receive this form, you must contact the Apprenticeship Section.



Formulario
F100-019-000
 
OJT Information Request and Recommendation form

VRCs can use this form to request information on a specific on -the -job (OJT) training opportunity listed on L&I's website, or to recommend an OJT training opportunity.



Formulario
F280-032-000
 
Request for Change of Status - Apprenticeship/Training Agreements and Training Agents

Used to request a change of status for apprentices, the training agreements or the training agents. These are normally accompanied by Committee meeting minutes when submitted.



Formulario
F100-021-000
 
Option 2: What You Need to Know, Vocational Rehabilitation Services
Booklet: Explains what happens when an individual selects "Option 2" and choose not to participate in the approved training plan.

Publicación
F280-036-000
 
The Apprenticeship Advantage: Earn While You Learn!
Fact sheet: Introduces apprenticeship to younger people. Explains the benefits of apprenticeship, a program of study where apprentices earn wages while learning a skilled profession. Includes contact information for L&I's apprenticeship coordinators around the state.

Publicación
F100-022-000
 





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