Reproduction Instructions

Non-Optical Character Recognition (OCR) Forms

Non-OCR forms do not require reproduction by printers or software companies. These forms may be downloaded from the Internet as needed, completed and submitted to the Bureau.
The following instructions must be followed exactly when reproducing your forms. The Bureau of Workers' Compensation will return forms to those who fail to conform to these instructions. Forms returned for this reason will not be considered filed, which will delay forms processing.


Use 20 lb. white paper, non-glossy, bright white. Reproduction on a lithographic press or a laser printer is required.


It is essential that these forms be reproduced exactly like the sample with special attention to the spacing. Acquisition and use of the forms on soft copy will enable correct spacing.


Within Pennsylvania, toll free: 1-800-482-2383.
Outside Pennsylvania and local calls: 717-772-4447
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