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83
![Form K-WC E-3 "Application for Preliminary Hearing" - Kansas](https://data.templateroller.com/pdf_docs_html/2078/20785/2078549/form-k-wc-e-3-application-for-preliminary-hearing-kansas.png "Form K-WC E-3 "Application for Preliminary Hearing" - Kansas")
![Form K-WC E-6 "Application for Dismissal" - Kansas](https://data.templateroller.com/pdf_docs_html/2078/20785/2078546/form-k-wc-e-6-application-for-dismissal-kansas.png "Form K-WC E-6 "Application for Dismissal" - Kansas")
![Form K-WC E-5 "Application for Review and Modification" - Kansas](https://data.templateroller.com/pdf_docs_html/2078/20785/2078545/form-k-wc-e-5-application-for-review-and-modification-kansas.png "Form K-WC E-5 "Application for Review and Modification" - Kansas")
![Form K-WC E-4 "Application for Post Award Medical, Termination or Modification of Medical Benefits" - Kansas](https://data.templateroller.com/pdf_docs_html/2078/20785/2078544/form-k-wc-e-4-application-for-post-award-medical-termination-or-modification-of-medical-benefits-kansas.png "Form K-WC E-4 "Application for Post Award Medical, Termination or Modification of Medical Benefits" - Kansas")
![Form K-WC E-1 "Application for Benefits" - Kansas](https://data.templateroller.com/pdf_docs_html/2078/20785/2078547/form-k-wc-e-1-application-for-benefits-kansas.png "Form K-WC E-1 "Application for Benefits" - Kansas")
![Form K-WC E-2 "Surviving Spouse, Dependent or Heir Application for Benefits" - Kansas](https://data.templateroller.com/pdf_docs_html/2078/20785/2078548/form-k-wc-e-2-surviving-spouse-dependent-or-heir-application-for-benefits-kansas.png "Form K-WC E-2 "Surviving Spouse, Dependent or Heir Application for Benefits" - Kansas")
![K-WC Form D "Settlement Agreement - Final Receipt and Release of Liability" - Kansas](https://data.templateroller.com/pdf_docs_html/1816/18160/1816092/k-wc-form-d-settlement-agreement-final-receipt-and-release-liability-kansas.png "K-WC Form D "Settlement Agreement - Final Receipt and Release of Liability" - Kansas")
K-WC Form D "Settlement Agreement - Final Receipt and Release of Liability" - Kansas
Size: 220 KB
3 pages
![Form K-BEN32 "Availability Statement" - Kansas](https://data.templateroller.com/pdf_docs_html/1806/18061/1806140/form-k-ben-32-availability-statement-kansas.png "Form K-BEN32 "Availability Statement" - Kansas")
![Form K-BEN31 "Able and Available Statement - Medical Condition or Workers Compensation" - Kansas](https://data.templateroller.com/pdf_docs_html/1810/18107/1810723/form-k-ben-31-able-and-available-statement-medical-condition-or-workers-compensation-kansas.png "Form K-BEN31 "Able and Available Statement - Medical Condition or Workers Compensation" - Kansas")
![K-WC Form 50 "Election of Employee Not to Accept Coverage" - Kansas](https://data.templateroller.com/pdf_docs_html/1747/17478/1747866/k-wc-form-50-election-employee-not-to-accept-coverage-kansas.png "K-WC Form 50 "Election of Employee Not to Accept Coverage" - Kansas")
![K-WC Form 51 "Election of Employer to Cover Employees" - Kansas](https://data.templateroller.com/pdf_docs_html/1747/17478/1747868/k-wc-form-51-election-employer-to-cover-employees-kansas.png "K-WC Form 51 "Election of Employer to Cover Employees" - Kansas")
![K-WC Form 42 "Subpoena" - Kansas](https://data.templateroller.com/pdf_docs_html/1806/18062/1806276/k-wc-form-42-subpoena-kansas.png "K-WC Form 42 "Subpoena" - Kansas")
![K-WC Form 44 "Report of Fraud or Abuse (Confidential)" - Kansas](https://data.templateroller.com/pdf_docs_html/1747/17478/1747867/k-wc-form-44-report-fraud-or-abuse-confidential-kansas.png "K-WC Form 44 "Report of Fraud or Abuse (Confidential)" - Kansas")
![K-WC Form 13 "Worksheet for Settlements: Death Case" - Kansas](https://data.templateroller.com/pdf_docs_html/1810/18107/1810737/k-wc-form-13-worksheet-settlements-death-case-kansas.png "K-WC Form 13 "Worksheet for Settlements: Death Case" - Kansas")
![Form K-CNS010 "Employer Status Report" - Kansas](https://data.templateroller.com/pdf_docs_html/2078/20780/2078055/form-k-cns010-employer-status-report-kansas.png "Form K-CNS010 "Employer Status Report" - Kansas")
![Form K-ISH517 "Astm International F24 Committee Standards - Model Certification" - Kansas](https://data.templateroller.com/pdf_docs_html/2078/20785/2078542/form-k-ish517-astm-international-f24-committee-standards-model-certification-kansas.png "Form K-ISH517 "Astm International F24 Committee Standards - Model Certification" - Kansas")
![Form K-WC300 "Order Form for Workers Compensation Publications" - Kansas](https://data.templateroller.com/pdf_docs_html/2078/20780/2078056/form-k-wc300-order-form-for-workers-compensation-publications-kansas.png "Form K-WC300 "Order Form for Workers Compensation Publications" - Kansas")
![Form K-BEN233 "Income Tax Withholding Agreement" - Kansas](https://data.templateroller.com/pdf_docs_html/1806/18061/1806144/form-k-ben-233-income-tax-withholding-agreement-kansas.png "Form K-BEN233 "Income Tax Withholding Agreement" - Kansas")
![Form K-FRD307 "Unemployment Fraud Report" - Kansas](https://data.templateroller.com/pdf_docs_html/1806/18062/1806230/form-k-frd-307-unemployment-fraud-report-kansas.png "Form K-FRD307 "Unemployment Fraud Report" - Kansas")
![Form K-BEN990 "My (Re)employment Plan" - Kansas](https://data.templateroller.com/pdf_docs_html/1806/18061/1806149/form-k-ben-990-my-re-employment-plan-kansas.png "Form K-BEN990 "My (Re)employment Plan" - Kansas")
![Formulario K-ESLR106 "Reclamo De Sueldos" - Kansas (Spanish)](https://data.templateroller.com/pdf_docs_html/1810/18107/1810731/form-k-eslr-106-reclamo-de-sueldos-kansas.png "Formulario K-ESLR106 "Reclamo De Sueldos" - Kansas (Spanish)")
![Form K-BEN987 "Work Search Activity Log" - Kansas](https://data.templateroller.com/pdf_docs_html/2017/20170/2017069/form-k-ben987-work-search-activity-log-kansas.png "Form K-BEN987 "Work Search Activity Log" - Kansas")
![Form K-CNS100 "Quarterly Wage Report & Unemployment Tax Return" - Kansas](https://data.templateroller.com/pdf_docs_html/1735/17355/1735528/form-k-cns100-quarterly-wage-report-unemployment-tax-return-kansas.png "Form K-CNS100 "Quarterly Wage Report & Unemployment Tax Return" - Kansas")
![Form K-CNS032 "Employer Representative Authorization" - Kansas](https://data.templateroller.com/pdf_docs_html/1747/17478/1747853/form-k-cns-032-employer-representative-authorization-kansas.png "Form K-CNS032 "Employer Representative Authorization" - Kansas")
![Form K-BEN230 "Weekly Claims Request for Information - Worked Full Time" - Kansas](https://data.templateroller.com/pdf_docs_html/1806/18061/1806159/form-k-ben-230-weekly-claims-request-information-worked-full-time-kansas.png "Form K-BEN230 "Weekly Claims Request for Information - Worked Full Time" - Kansas")
![Form K-BEN317 "School Attendance" - Kansas](https://data.templateroller.com/pdf_docs_html/1806/18061/1806152/form-k-ben-317-school-attendance-kansas.png "Form K-BEN317 "School Attendance" - Kansas")
![Form K-BEN314 "Labor Dispute Statement - Claimant" - Kansas](https://data.templateroller.com/pdf_docs_html/1806/18061/1806150/form-k-ben-314-labor-dispute-statement-claimant-kansas.png "Form K-BEN314 "Labor Dispute Statement - Claimant" - Kansas")
![Form K-BEN312 "Health Care Provider's Certification" - Kansas](https://data.templateroller.com/pdf_docs_html/1801/18013/1801333/form-k-ben-312-health-care-provider-s-certification-kansas.png "Form K-BEN312 "Health Care Provider's Certification" - Kansas")
![Form K-ISH500 "Amusement Ride Daily Inspection Checklist" - Kansas](https://data.templateroller.com/pdf_docs_html/1816/18160/1816071/form-k-ish-500-amusement-ride-daily-inspection-checklist-kansas.png "Form K-ISH500 "Amusement Ride Daily Inspection Checklist" - Kansas")
![Form K-ISH502 "Amusement Ride - Report of Itinerary" - Kansas](https://data.templateroller.com/pdf_docs_html/1806/18061/1806176/form-k-ish-502-amusement-ride-report-itinerary-kansas.png "Form K-ISH502 "Amusement Ride - Report of Itinerary" - Kansas")
![K-WC Form 123 "Election of Employer of Volunteer Workers" - Kansas](https://data.templateroller.com/pdf_docs_html/1747/17478/1747857/k-wc-form-123-election-employer-volunteer-workers-kansas.png "K-WC Form 123 "Election of Employer of Volunteer Workers" - Kansas")
![K-WC Form 135 "Election of Employer of Public Service Workers" - Kansas](https://data.templateroller.com/pdf_docs_html/1747/17478/1747861/k-wc-form-135-election-employer-public-service-workers-kansas.png "K-WC Form 135 "Election of Employer of Public Service Workers" - Kansas")
![K-WC Form 137 "Election of a Noncompensated Volunteer Officer, Director or Trustee" - Kansas](https://data.templateroller.com/pdf_docs_html/1747/17478/1747864/k-wc-form-137-election-a-noncompensated-volunteer-officer-director-or-trustee-kansas.png "K-WC Form 137 "Election of a Noncompensated Volunteer Officer, Director or Trustee" - Kansas")
![Form K-CNS112 "Continuation Sheet - Adjustment to Quarterly Wage Report" - Kansas](https://data.templateroller.com/pdf_docs_html/1733/17332/1733283/form-k-cns-112-continuation-sheet-adjustment-to-quarterly-wage-report-kansas.png "Form K-CNS112 "Continuation Sheet - Adjustment to Quarterly Wage Report" - Kansas")
![K-WC Form 124 "Cancellation of Form K-Wc 123 - Cancellation of Election of Employer to Provide Workers Compensation Coverage for Volunteer Workers" - Kansas](https://data.templateroller.com/pdf_docs_html/1733/17333/1733325/k-wc-form-124-cancellation-form-k-wc-123-cancellation-election-employer-to-provide-workers-compensation-coverage-volunteer-workers-kansas.png "K-WC Form 124 "Cancellation of Form K-Wc 123 - Cancellation of Election of Employer to Provide Workers Compensation Coverage for Volunteer Workers" - Kansas")
![Form K-CNS101 "Continuation Sheet - Quarterly Wage Report & Unemployment Tax Return" - Kansas](https://data.templateroller.com/pdf_docs_html/1733/17332/1733282/form-k-cns-101-continuation-sheet-quarterly-wage-report-unemployment-tax-return-kansas.png "Form K-CNS101 "Continuation Sheet - Quarterly Wage Report & Unemployment Tax Return" - Kansas")
![Form K-RM002 "Request for Disclosure of Tax/Benefit Information" - Kansas](https://data.templateroller.com/pdf_docs_html/470/4705/470554/form-k-rm002-request-for-disclosure-of-tax-benefit-information-kansas.png "Form K-RM002 "Request for Disclosure of Tax/Benefit Information" - Kansas")
![Form K-BEN319 "Drug and Alcohol Statement - Employer" - Kansas](https://data.templateroller.com/pdf_docs_html/1816/18160/1816069/form-k-ben-319-drug-and-alcohol-statement-employer-kansas.png "Form K-BEN319 "Drug and Alcohol Statement - Employer" - Kansas")
![K-WC Form 317 "Order for Production of Records" - Kansas](https://data.templateroller.com/pdf_docs_html/1810/18107/1810744/k-wc-form-317-order-production-records-kansas.png "K-WC Form 317 "Order for Production of Records" - Kansas")
![Form K-CNS111 "Adjustment to Quarterly Wage Report" - Kansas](https://data.templateroller.com/pdf_docs_html/431/4319/431979/form-k-cns-111-adjustment-to-quarterly-wage-report-kansas.png "Form K-CNS111 "Adjustment to Quarterly Wage Report" - Kansas")
