KRS 342.190: Notice and claim to be in writing -- Contents.

The notice and claim shall be in writing. The notice shall contain the name and address of

the employee, and shall state in ordinary language the time, place of occurrence, nature

and cause of the accident, with names of witnesses, the nature and extent of the injury

sustained, and the work or employment in which the employee was at the time engaged,

and shall be signed by him or a person on his behalf, or, in case of his death, by any one

(1) or more of his dependents or a person on their behalf. The notic e may include the

claim.