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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

Qualified Servicing Entity (QSE)
Forms

The forms below are related to the QSE application process, the QSE annual recertification process, and the claims data reporting process. These forms should be utilized by entities applying to become a QSE, active QSEs that are required to submit annual reports and QSE’s submitting information on behalf of carriers. To view these forms you can click on the links below:

Applications & Annual Recertifications

 

Other Forms