OhioBWC - Worker - Form: (ACT Enrollment and Direct Deposit) | ||||
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ACT Enrollment and Direct Deposit Authorization (A-12) |
Introduction |
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Injured workers receiving disability benefits, excluding death and
temporary partial, are eligible for direct deposit and should use this form to
apply for it. Automatic Comp Transfer (ACT) deposits your workers' compensation payments into a checking or savings account of your choice
on the day payment is due. Note: If you're already receiving benefits through direct deposit, also known as electronic funds transfer, do not use this form. Use the Direct Deposit ACT Change (A-35) to make any changes in your direct deposit. |
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Required information
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If you have all the required information on hand, simply click the start button to begin. |