⇢

Fill in a Valid Oklahoma Wc 12 Template

The Oklahoma WC 12 form serves as a request for a rebate from the Workers’ Compensation Multiple Injury Trust Fund, allowing employers and insurance carriers to recoup a portion of their assessments paid for the previous calendar year. This form requires detailed information, including the employer’s identification and bank details, to ensure accurate processing. For those eligible, timely submission is crucial, as missing the deadline can lead to a reduction in the rebate amount.

To begin the process of filling out the Oklahoma WC 12 form, please click the button below.

Fill Out Document

Navigation

The Oklahoma WC-12 form serves as a vital document for employers seeking rebates from the Multiple Injury Trust Fund for the tax year. This form is specifically designed for own risk employers or insurance carriers who have made payments into the fund. It requires essential details such as the name of the employer or carrier, their federal identification number, and contact information. Additionally, it prompts the user to specify the total amount of payments made to the Multiple Injury Trust Fund and the rebate amount requested, which is calculated as two-thirds of the total payments. To ensure accuracy and accountability, the form includes a certification section where the representative must affirm the truthfulness of the information provided. Important deadlines are also highlighted; for instance, applications for rebates must be submitted by May 31 each year to avoid a reduction in the rebate amount. Furthermore, rebates will not be disbursed until after July 1. Proper submission of the form is crucial, as it directs the request to the Oklahoma Tax Commission's Account Maintenance Division, ensuring that employers receive the financial relief they are entitled to.

Document Properties

Fact Name	Description
Form Purpose	The WC-12 form is used to request a rebate from the Multiple Injury Trust Fund for tax purposes in Oklahoma.
Governing Law	The form is governed by the Oklahoma Workers' Compensation Act, specifically related to the Multiple Injury Trust Fund.
Eligibility	Eligible parties include own risk employers and insurance carriers who have made payments to the Multiple Injury Trust Fund.
Rebate Calculation	The rebate amount is calculated as two-thirds of the total payments made to the Multiple Injury Trust Fund.
Application Deadline	Applications for rebates must be submitted by May 31 of each year to avoid a reduction in the rebate amount.
Rebate Payment Timing	No rebates will be issued until after July 1 of each year.
Signature Requirement	The form must be signed by an authorized representative of the employer or insurance carrier, certifying the accuracy of the information provided.
Contact Information	Applicants must provide contact information, including a telephone number, on the form for any necessary follow-up.
Mailing Address	Completed forms should be mailed to the Oklahoma Tax Commission, Account Maintenance Division, in Oklahoma City.
Verification Process	The form includes sections for office use, where rebate amounts are verified and initialed by supervisors.

Common mistakes

Incorrect Calculation of Rebate Amount: Many individuals mistakenly calculate the rebate amount using incorrect fractions. Instead of using 2/3, some may use values like .666, .667, .6666, or .6667. This can lead to discrepancies in the rebate amount requested.
Missing Required Information: Failing to provide all necessary details can result in delays or denials. Essential information includes the name of the employer or insurance carrier, the Federal Employer’s Identification Number, and the bank details for direct deposit.
Late Submission: Submitting the WC-12 form after the deadline of May 31 can lead to a penalty. The Oklahoma Tax Commission will reduce the rebate amount by ten percent if the application is not submitted on time.
Signature and Authorization Issues: The form must be signed by an authorized representative of the employer or insurance carrier. Not having the correct signature or failing to print the name and title of the signer can cause the application to be rejected.

Misconceptions

Understanding the Oklahoma WC-12 form is essential for employers and insurance carriers seeking rebates from the Multiple Injury Trust Fund. However, several misconceptions often arise regarding this form. Here are six common misunderstandings:

Misconception 1: The WC-12 form is only for large employers.

This form is applicable to all eligible parties, regardless of size. Any employer or insurance carrier that has made payments to the Multiple Injury Trust Fund can apply for a rebate.

Misconception 2: Rebates are automatically issued without an application.

Rebates are not issued automatically. Employers must submit the WC-12 form to request their rebate. Failing to apply will result in no rebate being received.

Misconception 3: The deadline for submitting the form is flexible.

The deadline is strict. Applications must be submitted by May 31 each year. Late submissions will incur a 10% reduction in the rebate amount.

Misconception 4: Only payments made in the current year are eligible for rebates.

The WC-12 form allows for rebates on assessments paid for the previous calendar year. It is important to keep track of payments made in that timeframe.

Misconception 5: The calculation for the rebate is straightforward and does not require verification.

While the rebate is calculated as two-thirds of the total payments, it is crucial to ensure accuracy. Any discrepancies in calculations can lead to issues with the rebate amount.

Misconception 6: Submitting the form guarantees a rebate.

Submitting the WC-12 form does not guarantee a rebate. The application will be reviewed, and if any information is incorrect or incomplete, it may be denied.

Being aware of these misconceptions can help employers and insurance carriers navigate the rebate process more effectively.

Preview - Oklahoma Wc 12 Form

Form WC-12

Revised 1-2014

WORKERS’ COMPENSATION

MULTIPLE INJURY TRUST FUND REBATE REQUEST

FOR TAX YEAR

Name of Own Risk Employer or Insurance Carrier:

Federal Employer’s Identiication Number:

Street Address:

City, State and Zip Code:

Bank Routing Number:	Bank Account Number:	Checking
		Savings

1. Total Multiple Injury Trust Fund Payments:

2. Rebate Requested (2/3 of Amount Entered on Line 1.):

The undersigned hereby certiies, under penalty of perjury, that he/she has executed this rebate request of

his/her free and voluntary will and as the duly authorized representative of the own risk employer/carrier named above and that the information and amounts herein contained relect a true, accurate, and complete statement.

Signed (name of own risk employer/carrier)	Date:

By (signature)

Printed Name and Title:	Telephone Number:

Beginning January 1, 2003, the Oklahoma Tax Commission shall accept applications for rebates from all eligible parties for assessments paid pertaining to the previous calendar year. Beginning with the calendar year of 2007, if any party fails to apply for a rebate on or before May 31 of each year, the Tax Commission shall reduce the amount of the rebate in the application by ten percent (10%). No rebates shall be paid until after July 1 of each year.

MAIL TO: OKLAHOMA TAX COMMISSION

ACCOUNT MAINTENANCE DIVISION

2501 NORTH LINCOLN BLVD.

OKLAHOMA CITY, OK 73194

OFFICE USE ONLY

Veriied Rebate Amount: $ __________________________________		Supervisor Initials: _________________________________
Reviewed by: ____________________________________________		Approved by: _____________________________________
		Account Maintenance Division
Difference in rounding	Used .666 instead of 2/3	Used .667 instead of 2/3	Used .6666 instead of 2/3
Used .6667 instead of 2/3	Used ________ instead of 2/3

FAQ

What is the Oklahoma WC-12 form used for?

The Oklahoma WC-12 form is a request for a rebate from the Multiple Injury Trust Fund. Employers or insurance carriers use this form to apply for rebates on assessments paid for the previous calendar year. It is essential for parties that have made payments to the fund and wish to recover a portion of those payments.

Who is eligible to file the WC-12 form?

Eligibility to file the WC-12 form is extended to all own risk employers and insurance carriers who have made payments to the Multiple Injury Trust Fund. To qualify, these parties must have paid assessments during the previous calendar year and must submit their rebate request within the specified time frame.

What is the deadline for submitting the WC-12 form?

The deadline for submitting the WC-12 form is May 31 of each year. If the form is not submitted by this date, the Oklahoma Tax Commission will reduce the rebate amount by ten percent. Therefore, timely submission is crucial to maximize the potential rebate.

How is the rebate amount calculated?

The rebate amount is calculated as two-thirds of the total Multiple Injury Trust Fund payments made in the previous year. This calculation is reflected in the rebate requested section of the form, where the applicant must input the total payments and the corresponding rebate amount.

When will the rebates be paid out?

Rebates will not be paid until after July 1 of each year. This delay allows the Oklahoma Tax Commission to process all applications and determine the appropriate rebate amounts based on the submissions received.

Where should the completed WC-12 form be mailed?

Completed WC-12 forms should be mailed to the Oklahoma Tax Commission at the following address: Account Maintenance Division, 2501 North Lincoln Blvd., Oklahoma City, OK 73194. Ensure that the form is sent to the correct division to avoid delays in processing.

What happens if there are errors in the rebate calculation?

If there are errors in the rebate calculation, the Oklahoma Tax Commission may adjust the rebate amount based on their review. It is important for applicants to ensure that all information provided is accurate and complete to avoid complications in the rebate process.

⇓ Oklahoma Wc 12 PDF Form

Documents used along the form

The Oklahoma WC-12 form is an important document used for requesting rebates from the Multiple Injury Trust Fund. However, there are several other forms and documents that may be needed in conjunction with the WC-12 to ensure a smooth process. Below is a list of related documents that are often utilized.

Form WC-1: This form is the Employee's First Notice of Injury. It provides essential details about the injury, including when and how it occurred. Employers use this form to report the incident to the insurance carrier.
Form WC-2: Known as the Employer's Report of Injury, this document outlines the circumstances surrounding the injury from the employer's perspective. It is crucial for documenting the claim and ensuring compliance with reporting requirements.
Form WC-3: This is the Employee's Claim for Compensation form. It is used by employees to formally request benefits related to their work-related injuries. This form initiates the claims process and provides necessary information about the employee's medical treatment and lost wages.
Texas Quitclaim Deed: A legal document used to transfer any interest in real property without guaranteeing the title's validity. More information can be found at UsaLawDocs.com.
Form WC-6: The Notice of Controversy form is filed by the employer or insurance carrier if there is a dispute regarding the claim. It notifies the employee and the Workers' Compensation Commission of the disagreement and outlines the reasons for the dispute.
Form WC-7: This form is the Request for Hearing. If an employee or employer disagrees with a decision made regarding a claim, this document is used to request a formal hearing before the Workers' Compensation Commission.
Form WC-9: The Medical Report form is used by healthcare providers to document the employee's medical condition and treatment related to the injury. This information is vital for determining the extent of benefits owed to the injured employee.

Understanding these forms can simplify the process of filing for a rebate and navigating the workers' compensation system in Oklahoma. Each document plays a specific role in ensuring that all parties are informed and that the claims process is handled efficiently.

Guide to Using Oklahoma Wc 12

Filling out the Oklahoma WC-12 form is a straightforward process. After completing the form, you will submit it to the Oklahoma Tax Commission for processing. Be sure to provide accurate information to avoid delays in your rebate request.

Start by entering the Name of Own Risk Employer or Insurance Carrier at the top of the form.
Fill in the Federal Employer’s Identification Number (FEIN) below the name.
Provide the Street Address, City, State and Zip Code of the employer or insurance carrier.
Input the Bank Routing Number for the account where the rebate will be deposited.
Enter the Bank Account Number for the same account.
In the section labeled Total Multiple Injury Trust Fund Payments, write the total amount of payments made.
Calculate the Rebate Requested by taking two-thirds of the amount entered on Line 1 and write that amount in the designated space.
Sign the form, certifying that the information is true and complete.
Print your name and title below your signature.
Include a Telephone Number where you can be reached.

Once the form is completed, mail it to the Oklahoma Tax Commission at the address provided. Ensure that you submit your application before the deadline to avoid any penalties or reductions in your rebate amount.