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Fillable ACT Enrollment and Direct Deposit Authorization

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ACT Enrollment and Direct Deposit Authorization Ohio Bureau of Workers' Compensation Attn. Benefits Payable P.O. Box 15429 Columbus, Ohio 43215-0429 Instructions Attach a voided check or personal deposit slip containing the banking information and account number to your completed ACT Enrollment and Direct Deposit Authorization. We must have either a voided check or savings deposit slip to process your ACT...
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