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Division Director

Tanner Holloman

Assistant Director

Andrew Sabolic


Workers' Compensation
200 East Gaines Street
Tallahassee, FL 32399-0318
Workers' Compensation Claims
(800) 342-1741
Workers' Compensation Exemption/ Compliance
(850) 413-1609

Forms for Governmental Self-Insured Employers

A Governmental Self-Insured Employer is required by law to provide important information to the Division annually. The Division has developed rules and adopted prescribed forms for self-insurers to use for reporting required information to the Division. A summary of relevant statutes, rules and forms are below. Please use the forms below for reporting required information to the Division.

Required Forms:

Premium Related Forms: