Form C 230 Ohio is a tax form that taxpayers in the state of Ohio use to report their income and taxable deductions. The form can be used by individuals, businesses, or trusts, and must be filed with the Ohio Department of Taxation by the due date. There are a number of specific instructions that taxpayers must follow when completing Form C 230 Ohio, so it is important to understand the requirements before filing. This article will provide an overview of what you need to know about Form C 230 Ohio.
| Question | Answer |
|---|---|
| Form Name | Form C 230 Ohio |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | initialed, disfigurement, C-230, BWC |
Authorization to Receive Workers' Compensation Payment
Injured worker's name
Attorney's name
Claim number
Representative ID number
Instructions for completion
•You must complete this form in its entirety, including the correct claim number.
•You must file a separate authorization for each claim and for each application, motion or order.
BWC will not honor an authorization that is not completed in its entirety, is altered but not initialed by the party altering the form or is not timely filed.
Time limits for filing are as follows:
On all types of compensation, other than an application for the percentage of permanent partial compensation
•Prior to or at the hearing;
•Prior to the date of the payment of compensation (before the award is issued) whether the award of compensation was made at a hearing or made without a hearing.
On any compensation paid pursuant to a
•With the application or the agreement for permanent partial disability;
•With the application for the election of permanent partial from temporary partial;
•With the Industrial Commission of Ohio at the hearing;
•After the hearing but prior to the date of mailing of the hearing officer order.
I hereby authorize and direct BWC to mail directly to my attorney the compensation payment in the above numbered claim for the accrued portion of my award as specified below. You must specify the date of the application, request, motion or order.
Application, request, motion or order dated _____/_____/_____ for the type(s) of compensation listed below.
Check all that apply.
Temporary total |
Impairment of earning capacity |
Wage loss |
Violation of specific safety |
Change of occupation |
Facial disfigurement |
Scheduled loss |
Lump sum settlement |
Permanent total disability |
Percentage permanent partial |
Death benefits |
Lump sum advancement |
This authorization does not give my attorney the authority to cash or endorse a check on my behalf.
This authorization shall not continue in effect after BWC has paid said award(s) on the original application noted above unless there is a subsequent hearing, appeal or reconsideration after payment was made.
This authorization is not valid if it is filed beyond 18 months from the date of my signature.
Injured worker’s/claimant’s signature
Date