Form R-4 (BWC-6104) Application for Representative Identification Number (Rin) - Ohio

Form R-4 (BWC-6104) Application for Representative Identification Number (Rin) - Ohio

What Is Form R-4 (BWC-6104)?

This is a legal form that was released by the Ohio Bureau of Workers' Compensation - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form R-4 (BWC-6104)?
A: Form R-4 (BWC-6104) is an Application for Representative Identification Number (RIN) in Ohio.

Q: What is a Representative Identification Number (RIN)?
A: A Representative Identification Number (RIN) is a unique identification number assigned to a representative by the Ohio Bureau of Workers' Compensation (BWC).

Q: Who needs to fill out Form R-4?
A: Anyone acting as a representative for a claimant in workers' compensation matters in Ohio needs to fill out Form R-4.

Q: How do I obtain a Representative Identification Number (RIN)?
A: To obtain a Representative Identification Number (RIN), you need to fill out Form R-4 (BWC-6104) and submit it to the Ohio Bureau of Workers' Compensation (BWC).

Q: Is there a fee to apply for a Representative Identification Number (RIN)?
A: No, there is no fee to apply for a Representative Identification Number (RIN) in Ohio.

Q: What is the purpose of the Representative Identification Number (RIN)?
A: The Representative Identification Number (RIN) is used to identify and track the activities of representatives in workers' compensation matters in Ohio.

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Form Details:

  • Released on July 20, 2016;
  • The latest edition provided by the Ohio Bureau of Workers' Compensation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form R-4 (BWC-6104) by clicking the link below or browse more documents and templates provided by the Ohio Bureau of Workers' Compensation.

Download Form R-4 (BWC-6104) Application for Representative Identification Number (Rin) - Ohio

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