Get Payment Method Authorization - Lni Wa

Filling out the Payment Method Authorization form for L&I can streamline your payment method preferences. This guide provides a clear and supportive walkthrough of each section of the form to ensure you complete it correctly.

Follow the steps to fill out your Payment Method Authorization form.

1. Click ‘Get Form’ button to access the Payment Method Authorization form and open it in your preferred tool.
2. Enter your Claim/Folio/L&I Account Number, ensuring all information is accurate, as this is essential for identifying your account.
3. Fill in the Claimant Name. If you are an alternate recipient, provide your information in the designated section.
4. In the Your Information section, provide your Name, Social Security Number (optional), Mailing Address, Date of Birth (required for debit cards), Phone Number, City, State, and Zip Code.
5. Select your preferred payment method by checking one of the options for Direct Deposit, L&I Debit Card, or Paper Check. If choosing Direct Deposit, input your Bank Name, Routing Number, and Account Number (checking or savings).
6. If opting for the L&I Debit Card, provide the Routing Number (nine digits) for where the card should be sent, ensuring your mailing address is current.
7. Read the authorization statements carefully. By signing, you acknowledge that you understand the conditions regarding benefits and payment methods.
8. Sign the form and include the date of your signature. Ensure that all required fields are filled out clearly in blue or black ink.
9. Return the completed form to the Department of Labor and Industries via mail or fax, using the provided addresses.

Complete your Payment Method Authorization online today and manage your L&I payments effectively.