Document Submittal Form - Pleadings and Correspondence

DO NOT use this form to submit a Notice of Appeal. It will NOT be considered filed.

REQUIREMENTS:

  • You must have a docket number.
  • Use a separate transmission for each appeal. Transmissions containing more than one docket number will be rejected and filing will not be accomplished, unless the multiple docket numbers have been consolidated by the BIIA. WAC 263-12-01501(2)(d).
  • Submit in electronic format only. After successful submission, DO NOT SEND A HARD COPY.
  • Only ONE document per submission:
  • File size limit is 25Mb.
  • EXHIBIT files may be in PDF, JPG, JPEG, or MP4* formats.
  • All other files MUST be in PDF.
  • * Portable Document Format, Joint Photographic Experts Group, or MPEG-4 Part 14 
  • You must enter an email address to receive email confirmation of successful submission.
  • If you do not see "Your document has been submitted." your form has NOT been received by the BIIA.
  • Documents received after 5 p.m. will be deemed filed the next business day. WAC 263-12-015(3) and WAC 263-12-01501.

QUESTIONS: Please call 360-753-6823.

Submitter information

* indicates required field help  to display detail information
    
Your name:*  
Contact e-mail:*
Please Confirm e-mail:*

Document information

BIIA Docket number:*   If consolidated, use lowest docket number. Enter docket number (1234567) without space or dash.
   
Attach document:*    View Attached Document
 

 
- 1 document per submission
- Exhibits - PDF, JPG  (JPEG), or MP4 format
- All others PDF format only
- Maximum 25Mb

By clicking 'SUBMIT' I acknowledge the records I am submitting become a public record and are subject to public disclosure under Chapter 42.56 RCW. I certify that I have removed all personally identifying information that I want to keep private or confidential (for example, social security number, bank, credit card, and other financial information defined by RCW 9.35.005).