Authorization to Release Claim Information


Document Information
  How to complete a fillable form.
Title Authorization to Release Claim Information (Cambodian)
Document number F101-010-214
Document type Form
How to get this document
Check for alternate languages of this document
Valid dates 03/2014
Contact information Claims for Job Injuries , Managing Injured Workers' Claims
Websites

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.

Help us improve