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State Fund is the largest provider of workers’ compensation insurance in California. State Fund plays a stabilizing role in California’s economy by maintaining an open door policy, ensuring all employers have a strong and stable option for their workers’ compensation needs.

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Public Records Act Request Form

This form is provided for your convenience but is not required to request records. Providing contact information will allow us to reach you in the event we require additional information to fulfill your request.
You do not need to provide identification or the reason for your request. However, if you’d like to pick up records or have records sent to you, we will require sufficient contact information.
* Required field

Section A - Contact Information

Name:
Business Name (if any):
Address:
Apt. / Suite:
City:
State:
Zip Code:
Phone:
Email:

Section B - Record(s) Requested

Describe the information you are requesting. Be specific as possible and include enough detail to assist us in locating the record(s). *

Section C - Additional Information
Providing the information in Section C is voluntary.

Is this information being requested for pending or anticipated litigation in which State Fund may be a party?	YesNo
Is this request for media purposes?	YesNo