Form F800-122-000 Parent / Legal Guardian / Custodian of Minor Victims Wage Loss Request - Washington

What Is Form F800-122-000?

This is a legal form that was released by the Washington State Department of Labor and Industries - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form F800-122-000?
A: Form F800-122-000 is a Wage Loss Request form for the parent, legal guardian, or custodian of minor victims in Washington.

Q: Who can use this form?
A: This form can be used by the parent, legal guardian, or custodian of a minor victim in Washington.

Q: What is the purpose of this form?
A: The purpose of this form is to request reimbursement for lost wages incurred while caring for a minor victim.

Q: How do I fill out this form?
A: You will need to provide personal information, details about the minor victim, and information about your wage loss.

Q: Is there a deadline for submitting this form?
A: Yes, there is a deadline for submitting this form. It must be submitted within one year from the date of the incident or within one year from the minor victim's 18th birthday, whichever is later.

Q: Are there any supporting documents required?
A: Yes, you may need to provide proof of your wage loss, such as pay stubs or a letter from your employer.

Q: Is there a fee for submitting this form?
A: No, there is no fee for submitting this form.

Q: Can I request an interpreter to assist with filling out this form?
A: Yes, you can request an interpreter to assist with filling out this form if you have limited English proficiency.