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.

Form Details:

• Released on November 15, 2022;
• 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{class="scroll_to"} or browse more documents and templates provided by the Ohio Bureau of Workers' Compensation.