OH Form 21.4 2016 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. ___
CONSENT TO CHANGE OF NAME
The undersigned ___
[check one of the following 2 capacities
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OH Form 21.4 Form Versions
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How to fill out OH Form 214
How to fill out OH Form 21.4
01
Obtain OH Form 21.4 from the appropriate government or organizational website.
02
Read the instructions carefully to understand the required information.
03
Fill in your personal details: name, address, and contact information in the designated spaces.
04
Provide details regarding the specific claim or situation that requires this form.
05
Include any necessary supporting documents or evidence as instructed.
06
Review the completed form for accuracy and completeness.
07
Sign and date the form in the indicated area.
08
Submit the form as directed, whether online or via mail.
Who needs OH Form 21.4?
01
Individuals who are filing claims related to workplace injuries or illnesses.
02
Employers who need to document employee claims for workers' compensation.
03
Medical providers submitting information on behalf of a patient.
04
Legal representatives assisting clients with claims.
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People Also Ask about
Do you have to go to court to change your name in Ohio?
To change your name as an adult in Ohio, you will need to go through the probate court in your county. Each county's probate court will have specific paperwork. Once you fill out the forms accurately and completely, you will turn them in to your county clerk's office.
How much does it cost to legally change your name in the state of Ohio?
The court may choose to publish the name change application in the local newspaper. This may require the posting of additional funds with the court to cover the cost of publication. The filing fee is $83.60 for adult name changes. If publication is required, the filing fee is instead $153.60.
What are the requirements for a name change in Ohio?
You must be a resident of the county where you are requesting your name change for at least 60 days. Reason. You must have a valid reason to change your name (this can include personal preference). If your reason is to avoid debt or other obligations, you cannot change your name.
Can I change my child's last name without father's consent in Ohio?
The applicant for the name change of a minor should obtain the consent of both parents of the minor child. A signed and notarized Consent to Name Change should be obtained and filed by the consenting non-applicant parent(s).
How do I change my name legally in Ohio?
Filing the paperwork Get the forms. Use the Adult Name Change Form Assistant to find the forms for your county's Probate Court. Ask about the fees. Gather your identification and supporting documents. Complete the forms. Get the paperwork notarized. File your paperwork at the Probate Court.
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What is OH Form 21.4?
OH Form 21.4 is a form used by employers in the state of Ohio to report worker's compensation claims and related information.
Who is required to file OH Form 21.4?
Employers who have employees covered under Ohio's worker's compensation laws are required to file OH Form 21.4.
How to fill out OH Form 21.4?
To fill out OH Form 21.4, employers need to provide details about the employee, the injury, and any related medical treatment. The form typically requires specific information such as dates, description of the incident, and costs associated with the claim.
What is the purpose of OH Form 21.4?
The purpose of OH Form 21.4 is to document and report workplace injuries and illnesses to ensure compliance with state regulations and to facilitate the worker's compensation process.
What information must be reported on OH Form 21.4?
Information required on OH Form 21.4 includes the employee's name and details, the date and location of the injury, a description of the injury, the circumstances surrounding the incident, and medical treatment details.
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