This version of the form is not currently in use and is provided for reference only. Download this version of Form A-12 (BWC-0019) for the current year.
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.
Q: What is Form A-12 (BWC-0019)?
A: Form A-12 (BWC-0019) is the Act Enrollment and Direct Deposit Authorization form used in Ohio.
Q: What is the purpose of Form A-12 (BWC-0019)?
A: The purpose of Form A-12 (BWC-0019) is to enroll in the Act program and authorize direct deposit for benefits.
Q: What is the Act program?
A: The Act program is the Alternative Compensation program administered by the Ohio Bureau of Workers' Compensation (BWC).
Q: What is direct deposit?
A: Direct deposit is a payment method where funds are electronically transferred directly into the recipient's bank account.
Q: Why would I need to complete Form A-12 (BWC-0019)?
A: You would need to complete Form A-12 (BWC-0019) to enroll in the Act program and receive benefits through direct deposit.
Q: Are there any eligibility requirements for the Act program?
A: Yes, there are eligibility requirements for the Act program. It is best to check with the Ohio BWC for specific requirements.
Q: Can I choose not to enroll in the Act program?
A: Yes, enrollment in the Act program is optional.
Q: How long does it take to process Form A-12 (BWC-0019)?
A: Processing times may vary. It is recommended to contact the Ohio BWC for information on processing times.
Q: Can I change my direct deposit information after submitting Form A-12 (BWC-0019)?
A: Yes, you can change your direct deposit information by submitting a new Form A-12 (BWC-0019) with the updated information.
Form Details:
Download a printable version of Form A-12 (BWC-0019) by clicking the link below or browse more documents and templates provided by the Ohio Bureau of Workers' Compensation.