Get the free Ohio Employer's Representative Authorization (Form JFS 20106)

OHIO DEPARTMENT OF JOB AND FAMILY SERVICES P.O. BOX 182404 Columbus, Ohio 432182404 (614) 4662319 http://unemployment.ohio.govFOR 0006EMPLOYER\'S REPRESENTATIVE AUTHORIZATION To immediately authorize

How to fill out ohio employers representative authorization

How to fill out ohio employers representative authorization

1. Obtain the Ohio Employers Representative Authorization Form from the Ohio Bureau of Workers' Compensation website or office.
2. Fill in the required information such as the employer's name, address, and contact details.
3. Provide the name of the authorized representative and their contact information.
4. Indicate the effective date and duration of the authorization.
5. Sign and date the form.
6. Submit the completed form to the Ohio Bureau of Workers' Compensation by mail, fax, or electronically.

Who needs ohio employers representative authorization?

1. Employers in Ohio who want to authorize a representative to act on their behalf in matters related to workers' compensation need to fill out the Ohio Employers Representative Authorization.

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What is ohio employers representative authorization?

Ohio Employers Representative Authorization is a form that allows an individual or organization to act on behalf of an employer in matters related to the Ohio Bureau of Workers' Compensation (BWC).

Who is required to file ohio employers representative authorization?

Employers in Ohio who wish to designate an individual or organization to represent them in dealings with the Ohio BWC must file the Ohio Employers Representative Authorization.

How to fill out ohio employers representative authorization?

To fill out the Ohio Employers Representative Authorization, you need to provide the employer's information, the representative's details, and specify the scope of authority granted to the representative.

What is the purpose of ohio employers representative authorization?

The purpose of the Ohio Employers Representative Authorization is to ensure that employers can have appointed representatives who can handle their workers' compensation matters efficiently and securely.

What information must be reported on ohio employers representative authorization?

The form must include the employer's name, account number, representative's name, contact information, and the extent of the authority granted to the representative.