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Workers’ Comp Applications & Forms

All our forms are available for download. Just click the + to expand the section, then just click the document you’d like to download. You can also right-click the download button to get a link you can share with your customers or staff.

Applications & Forms

TitleSizeDate modifiedDownload
ACORD 130-FL Instructions 206.96 KB03-30-2022 DownloadPreview
Acord 130 120.08 KB03-30-2022 DownloadPreview
Acord 130-FL 161.59 KB03-30-2022 DownloadPreview
AmTrust EFT Form 46.56 KB03-30-2022 DownloadPreview
Amerisafe Map 223.46 KB03-30-2022 DownloadPreview
Binding-ACORD 66.81 KB03-30-2022 DownloadPreview
Certificate Guide 84.36 KB03-30-2022 DownloadPreview
Drug Free 258.63 KB03-30-2022 DownloadPreview
ERM-14 131.54 KB03-30-2022 DownloadPreview
Employers PayGo 96.61 KB03-30-2022 DownloadPreview
FL Contracting Class Credit App 162.63 KB03-30-2022 DownloadPreview
Florida Contractor Credit Guide 346.14 KB03-30-2022 DownloadPreview
Florida Drug-Free Credit Guide 71.80 KB03-30-2022 DownloadPreview
Florida Exemption Rules 343.53 KB05-06-2022 DownloadPreview
Florida Officer Revocation Forms 27.30 KB03-30-2022 DownloadPreview
Frank Crum Cert Request Form 236.59 KB03-30-2022 DownloadPreview
KymberlyGroup Cert Request Form 139.78 KB03-30-2022 DownloadPreview
Lost Policy Release for Cancellation 6.11 KB03-30-2022 DownloadPreview
MCIM Classes 253.76 KB03-30-2022 DownloadPreview
NCCI Construction Classes 35.59 KB03-30-2022 DownloadPreview
No Loss Affidavit 14.52 KB03-30-2022 DownloadPreview
Officer Inclusion 17.96 KB03-30-2022 DownloadPreview
Officer Min-Max by State 85.31 KB03-30-2022 DownloadPreview
Omega Binder – Things You Need to Know 207.46 KB03-30-2022 DownloadPreview
PA Application for Executive Officer’s Declaration 227.12 KB03-30-2022 DownloadPreview
PA Executive Officer’s Declaration 222.13 KB03-30-2022 DownloadPreview
SUNZ Loss History Affidavit 294.65 KB03-30-2022 DownloadPreview
Safety Credit 256.87 KB03-30-2022 DownloadPreview
Sample Workplace Drug Free Policy 100.73 KB03-30-2022 DownloadPreview
WC Class Codes 617.92 KB03-30-2022 DownloadPreview
WC Rates Effective 1-2-22 110.55 KB03-30-2022 DownloadPreview
Wrap Ups 120.97 KB03-30-2022 DownloadPreview

Supplemental Forms

TitleSizeDate modifiedDownload
Ambulance Questionnaire 91.51 KB03-30-2022 DownloadPreview
Any CC Questionnaire 123.57 KB03-30-2022 DownloadPreview
Assisted Living Questionnaire 102.01 KB03-30-2022 DownloadPreview
Auto Dealers Supplemental 122.12 KB03-30-2022 DownloadPreview
Auto Repair 21.11 KB03-30-2022 DownloadPreview
Bar Supplemental 119.87 KB03-30-2022 DownloadPreview
Blank USLH 572.03 KB03-30-2022 DownloadPreview
Brewery Supplemental 2.88 MB03-30-2022 DownloadPreview
Cable Installation Supplemental 108.19 KB03-30-2022 DownloadPreview
Catering Supplemental 18.52 KB03-30-2022 DownloadPreview
Cert Issuance Guide 84.36 KB03-30-2022 DownloadPreview
Construction Supplemental 312.94 KB04-06-2022 DownloadPreview
Day Care Center Supplemental 22.25 KB03-30-2022 DownloadPreview
Delivery Supplemental 202.98 KB03-30-2022 DownloadPreview
Distributors Supplemental 72.76 KB03-30-2022 DownloadPreview
Domestic Supplemental 968.62 KB03-30-2022 DownloadPreview
Engineering Firm Supplemental 92.80 KB03-30-2022 DownloadPreview
Excavation Supplemental 310.11 KB03-30-2022 DownloadPreview
Farm Supplemental 10.47 KB03-30-2022 DownloadPreview
Freight Forwarding Supplemental 93.60 KB03-30-2022 DownloadPreview
Health Care Supplemental 150.48 KB03-30-2022 DownloadPreview
Home Health Care 111.97 KB03-30-2022 DownloadPreview
Home Health Care Professional Services 113.87 KB03-30-2022 DownloadPreview
Hotel & Motel 26.50 KB03-30-2022 DownloadPreview
Janitorial Supplemental 189.01 KB03-30-2022 DownloadPreview
Landscaping Supplemental 149.68 KB03-30-2022 DownloadPreview
Logging Supplemental 58.43 KB03-30-2022 DownloadPreview
Manufacturing Rep Supplemental 88.03 KB03-30-2022 DownloadPreview
New Agents to WC 87.17 KB03-30-2022 DownloadPreview
Pawn Brokers Supplemental 108.79 KB03-30-2022 DownloadPreview
Pest Control Supplemental 80.49 KB03-30-2022 DownloadPreview
Pizza & Restaurant Delivery Supplemental 202.65 KB03-30-2022 DownloadPreview
Property Management Supplemental 131.64 KB03-30-2022 DownloadPreview
Recycling Waste Dism-Scr Questionnaire 157.11 KB03-30-2022 DownloadPreview
Restaurant Supplemental 26.70 KB03-30-2022 DownloadPreview
Retail-Wholesale Supplemental Application 27.08 KB03-30-2022 DownloadPreview
Schools Supplemental Application 135.46 KB03-30-2022 DownloadPreview
Scrap Operations 573.71 KB03-30-2022 DownloadPreview
Security Guards 120.96 KB03-30-2022 DownloadPreview
Social Services Supplemental 29.66 KB03-30-2022 DownloadPreview
Tow Truck Supplemental 369.74 KB03-30-2022 DownloadPreview
Trav Supplemental – Construction 56.33 KB03-30-2022 DownloadPreview
Tree Pruning Supplemental 1.75 MB03-30-2022 DownloadPreview
Trucking Supplemental Application 87.59 KB03-30-2022 DownloadPreview
USL&H Supplemental 572.07 KB03-30-2022 DownloadPreview
Wholesalers 38.16 KB03-30-2022 DownloadPreview