Get Wa F213-042-000 2018-2025

The WA F213-042-000 form, also known as the Application for Elective Coverage, allows sole proprietors, partners, corporate officers, and LLC members to elect coverage for certain excluded employments under Washington's Industrial Insurance laws. This guide will navigate you through the process of completing this form online with ease.

Follow the steps to successfully complete the WA F213-042-000.

1. Click the ‘Get Form’ button to access the WA F213-042-000 and open it for editing.
2. Begin by determining your business entity type (sole proprietor, partner, for profit corporation, or LLC) and check the corresponding box at the top of the form.
3. Fill in your business name and address accurately to ensure proper identification.
4. Provide your Unified Business Identifier (UBI) and Account ID, as it is essential for processing your application.
5. Enter the contact name and phone number for follow-up inquiries from the Department of Labor and Industries.
6. Complete the section for exempt corporate officers, partners, or LLC members who are electing coverage. Each individual must sign and provide their details, including position, duties, social security number, date of birth, and percentage of ownership.
7. Review the understanding statement outlining responsibilities regarding the reporting of hours and premiums.
8. After ensuring all required fields are filled and accurate, save your changes and download or print your completed form.
9. Submit the completed form to the appropriate address as specified, depending on whether you are requesting state fund or self-insurance coverage.

Start completing the WA F213-042-000 online application today to ensure your coverage.