Pennsylvania Supplemental Agreement Form Compensation For Death is a form used by employers in the state of Pennsylvania to provide a supplemental payment to the beneficiaries of an employee who has died due to an injury or illness acquired in the course and scope of their employment. The form is typically used when the worker’s deatcompensatele under the Pennsylvania Workers’ Compensation Act and the employer does not have a collective bargaining agreement in place providing death benefits to the beneficiary. The form is designed to provide additional funds to the surviving family members who are otherwise not covered by the death benefits provided in the workers’ compensation claim. There are three types of Pennsylvania Supplemental Agreement Form Compensation For Death: Lump-Sum Payment, Annuity Payment, and Multiple Payment. The Lump-Sum Payment is a single payment made to the beneficiary upon the death of the employee. The Annuity Payment is an ongoing payment to the beneficiary for a certain period of time. The Multiple Payment is a combination of a lump-sum payment and an annuity payment.