Self-Insured Employer's Certification of Assignment After Initial Allowance Forms
| Form Name | Self-Insured Employer's Certification of Assignment After Initial Allowance |
| Form # | BWC-1394 C-262 |
| Form Revision | (REv. April 23, 2024) |
| Category | Forms » Insurance |
| Downloads | |
| Form State | Ohio |
| Language | English |
| State Description | n/a |
| Claimwire Description | n/a |