Form A-12 (BWC-0019) Act Enrollment and Direct Deposit Authorization - Ohio

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Form A-12 (BWC-0019) Act Enrollment and Direct Deposit Authorization - Ohio

What Is Form A-12 (BWC-0019)?

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 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.

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Form Details:

  • Released on September 21, 2010;
  • The latest edition provided by the Ohio Bureau of Workers' Compensation;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

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.

Download Form A-12 (BWC-0019) Act Enrollment and Direct Deposit Authorization - Ohio

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