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    Linda Repp   

Request for employer coverage information

If you want to identify an employer’s insurer, fill out and submit this on-line form. The Workers’ Compensation Division will reply with coverage information as requested.

Requester’s e-mail address (required): 
Employer’s doing-business-as name: 
Employer’s legal name: 
Employer’s street address: 
Employer’s city: 
Time period or date of coverage needed: 


If you have questions about this webpage, please contact Linda Repp, 503-947-7664.