Please use the following links to access these forms used in the Division of Workers' Compensation Funds.

  
Address Change Request Form (Printable PDF)
Direct Deposit Form (Printable PDF)
Reimbursement Request Form (Printable PDF)
Reimbursement Request Form (Editable DOCX)
Address Change Request Form (Editable DOTX)
Direct Deposit Form (Editable DOTX)


 
 
 
 
 
 
 
 
 
 
Division of Workers Compensation Funds
1047 U.S. Highway 127 South, Suite 4
Frankfort KY  40601
Phone: (502) 564-5467
Fax: (502) 564-5112