To report a claim use the following phone numbers for your respective carrier:

You can view these two forms online Adobe Acrobat PDF format by clicking on the appropriate form to the right.  Then you can print the form, fill it out, and fax or mail it to Penta. 

You will need the Adobe Acrobat Reader to view the forms. . .

Click here to download the reader

 

Business Owner

Application

(Form 160)

 

Workers Comp

Application

Form (130)

 

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P.O.Box 248, 574 Red Lion Road, Huntingdon Valley, PA 19006
Phone: (215) 947-8300   ~    Fax: (215) 947-4231   ~    E-Mail
Hours: Monday - Friday, 8:00 AM to 5:00 PM