Legal service provider electronic funds transfer (EFT) application form

A form for legal service providers to nominate bank details to receive electronic payments from Worksafe's authorised agents.


What it contains

This form should be used by legal firms wishing to set up their offices with EFT payments for legal costs and lump sum payments only. Please note firms must provide details of their trust account in order to receive payment of lump sum settlements by way of EFT. Legal costs payments may be made into either a trust account or an office account.

Please note that only one form per firm is required. Please use the appendix attached to the form in the event that your firm has more than one service provider number.

If you require assistance completing the EFT form or would like a current list of service provider numbers associated with your firm, please contact [email protected]