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The Oklahoma WC-12 form serves a crucial purpose for employers and insurance carriers participating in the state's Workers' Compensation Multiple Injury Trust Fund. This form is specifically designed for those who wish to request a rebate for the tax year, based on their contributions to the fund. To initiate the rebate process, employers must provide essential information, including their name, Federal Employer Identification Number, and contact details. The form also requires the total amount of Multiple Injury Trust Fund payments made and calculates the rebate requested, which is two-thirds of that total. It is vital for the applicant to certify the accuracy of the information provided, affirming that they are authorized to submit the request. The deadline for submitting this form is May 31 of each year, after which any late applications may incur a reduction in the rebate amount. Additionally, rebates are not issued until after July 1, ensuring that the Oklahoma Tax Commission has adequate time to process requests. Proper completion and timely submission of the WC-12 form can significantly impact the financial responsibilities of employers and enhance their ability to manage costs associated with workers' compensation.

Important Questions on Oklahoma Wc 12

What is the purpose of the Oklahoma WC 12 form?

The Oklahoma WC 12 form is used to request a rebate from the Workers’ Compensation Multiple Injury Trust Fund. Employers or insurance carriers who have made payments to this fund can apply for a rebate for tax purposes. This form is essential for ensuring that eligible parties receive the correct amount of rebate based on their contributions to the fund.

Who is eligible to submit the WC 12 form?

Eligibility to submit the WC 12 form is granted to all own risk employers or insurance carriers that have made assessments to the Multiple Injury Trust Fund. It is important that the applicant is the duly authorized representative of the employer or carrier, as they must certify the accuracy of the information provided in the form.

What is the deadline for submitting the WC 12 form?

The deadline for submitting the WC 12 form is May 31 of each year. Failure to submit the application by this date will result in a reduction of the rebate amount by ten percent. It is crucial to adhere to this deadline to ensure that the full rebate amount can be received.

Where should the completed WC 12 form be sent?

Once completed, the WC 12 form should be mailed to the Oklahoma Tax Commission, specifically to the Account Maintenance Division. The address is as follows: 2501 North Lincoln Blvd., Oklahoma City, OK 73194. Ensuring that the form is sent to the correct address will help avoid delays in processing the rebate request.

How to Write Oklahoma Wc 12

Completing the Oklahoma WC-12 form requires careful attention to detail. The information you provide will help process your rebate request accurately. Follow these steps to fill out the form correctly.

  1. Begin by entering the Name of Own Risk Employer or Insurance Carrier at the top of the form.
  2. Provide the Federal Employer’s Identification Number in the designated space.
  3. Fill in the Street Address, City, State and Zip Code of the employer or insurance carrier.
  4. Enter the Bank Routing Number for the account where the rebate will be deposited.
  5. Indicate the Bank Account Number associated with the routing number provided.
  6. In line 1, state the Total Multiple Injury Trust Fund Payments made.
  7. Calculate the Rebate Requested by multiplying the amount on line 1 by 2/3 and enter this figure on line 2.
  8. Sign the form as the own risk employer/carrier in the designated area.
  9. Provide the date of signing.
  10. Print your Name and Title beneath your signature.
  11. Include a Telephone Number for contact purposes.

After completing the form, ensure all information is accurate before submitting it. Mail the form to the address provided to ensure it is processed in a timely manner.

Similar forms

The Oklahoma WC-12 form is similar to the IRS Form 941, which is used by employers to report income taxes, Social Security tax, and Medicare tax withheld from employee wages. Both forms require accurate reporting of financial information and must be filed within specific deadlines. While the WC-12 focuses on requesting rebates for payments made to the Multiple Injury Trust Fund, Form 941 emphasizes the employer's tax obligations. Each form includes certification by the employer, ensuring that the information provided is truthful and complete.

Another comparable document is the Oklahoma WC-3 form, which is the Employer's Report of Injury. Like the WC-12, the WC-3 serves a crucial role in the workers' compensation process. It captures essential details about workplace injuries and must be submitted to the Oklahoma Workers' Compensation Commission. Both forms require the employer’s identification and emphasize the importance of accuracy. However, while the WC-12 is about requesting financial rebates, the WC-3 focuses on reporting incidents and claims related to employee injuries.

The Oklahoma Form 1099-MISC also shares similarities with the WC-12. This form is used to report various types of income other than wages, salaries, and tips. Both documents require the identification of the payer and the recipient, along with specific financial details. They are essential for tax reporting purposes, ensuring that all parties involved have a clear understanding of the amounts being reported. However, while the WC-12 is specifically tied to workers' compensation rebates, the 1099-MISC encompasses a broader range of income types.

The IRS Form 990, which is used by tax-exempt organizations to provide information on their financial activities, is another document that bears resemblance to the WC-12. Both forms require detailed financial information and aim to ensure transparency and accountability. While the WC-12 is focused on rebates related to workers' compensation, Form 990 provides a comprehensive overview of an organization’s financial health, including revenue, expenses, and governance practices.

The Oklahoma WC-12 form is similar to the IRS Form 941, which is used for reporting employer payroll taxes. Just as the WC-12 facilitates the request for rebates related to workers' compensation, Form 941 allows employers to report income taxes withheld and FICA taxes. Both forms require accurate financial information and official signatures, underscoring the importance of compliance. Inaccuracies on either form can lead to penalties, reflecting the need for diligence in reporting. For additional guidance, resources like legalpdf.org can be useful.

The Oklahoma Form 1040 is also similar to the WC-12 in that it requires taxpayers to report their income and claim deductions or credits. Both forms necessitate accurate reporting and include a declaration of the information's truthfulness. The WC-12 specifically targets rebates related to workers' compensation payments, while the 1040 covers a broader scope of personal income tax obligations, reflecting the diverse financial responsibilities of individuals.

Lastly, the Oklahoma Form 20 is akin to the WC-12 as it is used for reporting unemployment insurance claims. Both documents require the employer's information and detailed financial data. They are essential for ensuring compliance with state regulations. However, the WC-12 is specifically focused on rebates from the Multiple Injury Trust Fund, while Form 20 addresses unemployment benefits, highlighting different aspects of employee compensation and employer responsibilities.

Example - 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

 

 

 

 

 

 

Documents used along the form

When dealing with workers' compensation claims in Oklahoma, several forms and documents may accompany the WC-12 form. Each of these documents serves a specific purpose in the claims process. Below is a list of some commonly used forms.

  • Form WC-1: This is the "Employee's First Notice of Injury" form. It notifies the employer of an employee's injury and initiates the claims process. It includes details about the injury and the circumstances surrounding it.
  • Form WC-3: Known as the "Employer's Report of Injury," this form is completed by the employer after receiving notice of the employee's injury. It provides the insurance carrier with necessary information to process the claim.
  • Form WC-5: This form is the "Claim for Compensation." It is used by the injured employee to formally request compensation for medical expenses and lost wages due to the injury.
  • Form WC-6: The "Notice of Denial" form is completed by the employer or insurance carrier when a claim is denied. It outlines the reasons for the denial and is crucial for the employee's understanding of their claim status.
  • Form WC-7: This is the "Request for Hearing" form. An employee may use this form to appeal a denial or dispute regarding their workers' compensation claim, seeking a formal hearing before the Workers' Compensation Court.
  • Medical Power of Attorney: This form is vital for anyone wishing to appoint someone to make healthcare decisions on their behalf when they are unable to. For more information, visit https://arizonapdfforms.com/medical-power-of-attorney/.
  • Form WC-8: The "Settlement Agreement" form is utilized when both parties agree to settle the claim outside of court. It outlines the terms of the settlement and is important for finalizing the agreement.
  • Form WC-9: This form is the "Final Report of Injury." It is submitted by the employer to report the conclusion of the claim process, indicating whether the employee has returned to work or if further actions are needed.

Each of these forms plays a vital role in the workers' compensation process in Oklahoma. Understanding their functions can help ensure that all necessary information is submitted accurately and timely, facilitating smoother claims management.

Key takeaways

Filling out and using the Oklahoma WC-12 form requires attention to detail and adherence to specific guidelines. Here are key takeaways to keep in mind:

  • Eligibility: Ensure that you are an eligible party to apply for a rebate on assessments paid from the previous calendar year.
  • Timeliness: Submit your application for a rebate by May 31 each year to avoid a 10% reduction in the rebate amount.
  • Accurate Information: Provide accurate details, including the name of the employer or insurance carrier, Federal Employer Identification Number, and contact information.
  • Payment Calculation: Calculate the rebate by entering 2/3 of the total Multiple Injury Trust Fund payments on Line 2.
  • Signature Requirement: The form must be signed by a duly authorized representative of the employer or carrier, affirming the accuracy of the information provided.
  • Mailing Instructions: Send the completed form to the Oklahoma Tax Commission at the specified address to ensure it is processed correctly.
  • Post-Submission: Be aware that rebates will not be paid until after July 1 of each year, so plan accordingly.