You’re offline. This is a read only version of the page.
Official Government Website
Toggle navigation
Home
Forms
Forms
EXT Request
Public Records Request
Sign in
Extraterritorial Request
1
Employer Information
2
Employee Information
3
Completed By
Employer Name and Contact Information:
Business Legal Name
*
Business Name Used other than Business Legal Name
*
Physical Address (Street, City, State, Zip Code)
*
Phone Number
*
Email
*
*
Duration/Type of Work to be Performed in Idaho
Work Type
*
Work Type
Intermittent
Work Type
Temporary
Intermittent Work Percentage
*
*
Expected Start Date
*
*
Expected End Date
*
