Department of Labor and Industries Cashier's Office PO Box 44835 Olympia WA 98504-4835
REQUEST FOR MANUALS FROM CLAIMS TRAINING
Number Requested Price Per Unit $49.44* $79.44* (Manual Set) Not sold separately Total Amount Enclosed
$0.00
RESET
Type of Manual Requested Total Cost
State Fund Claims Policy Manual Manual Set
Workers' Compensation Adjudicator (WCA) Manual and Claims Management (CM) Manual
*Price includes printing, binders, tax and shipping. The breakdown of this manual price is available upon request.
Shipping Information
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Phone
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PLEASE ALLOW UP TO 4 WEEKS FOR DELIVERY Return this form and your check to:
Department of Labor and Industries Cashier's Office PO Box 44835 Olympia WA 98504-4835
LABOR AND INDUSTRIES OFFICE USE ONLY Cashier Office Received (See Claims Training Code Sheet) Date
Please return this form to Claims Training, MS4208, after completion.
F241-021-000 request for manuals from claims training 05-2005