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For benefits to continue without interruption, this. Declaration of Entitlement must be completed in full, signed, notarized and returned within 30 days.Download Declaration of Entitlement - Disabled Child or Guardian Benefits (F242-421-000) – Department of Labor and Industries (Washington) form. Form Name, Declaration of Entitlement For Disabled Child or Guardian Benefits Under Industrial Insurance. Acceptable Document(s) to Verify Eligibility. Spouse. This page is the portal for the Kids and Families website. Declaration of Disability. FOR OVER-AGE DEPENDENT CHILD. Means-Tested Benefits of Form I-912. Dependent may make taxpayers eligible for other tax benefits.