OH From 21.3 2016-2025 free printable template
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PROBATE COURT OF ___ COUNTY, OHIO
IN RE: CHANGE OF NAME OF___
(Present Name)TO ___
(Name Requested)CASE NO. ___
JUDGMENT ENTRY CHANGE OF NAME OF MINOR
On ___an application for change of name was heard
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Obtain the OH Form 21.3 from the appropriate agency or website.
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Answer each question accurately and concisely, ensuring that you do not leave any required fields blank.
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Who needs OH From 21.3?
01
Individuals applying for specific benefits or services that require the completion of OH Form 21.3.
02
Employers needing to verify information related to workplace safety or health assessments.
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Health care professionals assisting patients with administrative health-related paperwork.
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Organizations conducting research or data collection that includes health and safety information.
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What is OH Form 21.3?
OH Form 21.3 is a form used in Ohio for reporting employee injuries or illnesses that occur in the workplace, specifically for the Bureau of Workers' Compensation.
Who is required to file OH Form 21.3?
Employers in Ohio who have employees that experience work-related injuries or illnesses are required to file OH Form 21.3.
How to fill out OH Form 21.3?
To fill out OH Form 21.3, employers need to provide details such as the employee's information, the nature of the injury or illness, the date it occurred, and any medical treatment received.
What is the purpose of OH Form 21.3?
The purpose of OH Form 21.3 is to document and report work-related injuries and illnesses for the proper processing of workers' compensation claims.
What information must be reported on OH Form 21.3?
Information that must be reported on OH Form 21.3 includes the employee's name, address, social security number, date of injury, details of the injury, and any treatment provided.
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