Facing issues with the submission of documents to the Bureau of Workers' Compensation (BWC) is a scenario that many individuals and businesses find themselves in, often culminating in the need to engage with the BWC 1274 form. The primary purpose of this form is to address and rectify any instances where documents cannot be processed due to specific missing information or inaccuracies that prevent the BWC from proceeding with a claim or inquiry. This form acts as a crucial step in ensuring that the necessary corrections can be made, whether it involves providing a missing or invalid claim number, the full name of the injured worker, their Social Security number, the date of the injury, the employer at the time of said injury, or any other essential details not originally included or correctly stated. Not only does it facilitate a smoother communication channel between the applicant and the BWC customer service office, but it also underscores the importance of accuracy and completeness in the submission process. Moreover, the form contains sections for the contact details of the BWC customer service representative handling the case, along with the required applicant's signature and date, certifying the truthfulness and correctness of the provided information, thereby placing a significant emphasis on the integrity of the information being submitted or corrected.
| Question | Answer |
|---|---|
| Form Name | Form Bwc 1274 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | digit, BWC, c147, Applicant |
BWC could not process the attached document for the following reason(s):
To research our records, please provide the following information as indicated by the block(s) checked:
Missing or invalid claim number; |
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The injured worker's full name; |
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The injured worker's social security number; |
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Date of injury; |
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Employer at the time of the injury; |
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Other |
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Please provide the information checked above for the attached document and return both to the
BWC customer service ofice listed below. If you need further assistance, contact this ofice at the
number provided below.
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BWC |
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Address |
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I certify the information I have provided is truthful and correct. |
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Applicant signature |
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Date |
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