Request to Correct Employer and/or Policy Number Assignment Forms
| Form Name | Request to Correct Employer and/or Policy Number Assignment |
| Form # | BWC-1396 C-264 |
| Form Revision | (Rev. April 25, 2024) |
| Category | Forms » Board/Commission/Division |
| Downloads | |
| Form State | Ohio |
| Language | English |
| State Description | n/a |
| Claimwire Description | n/a |