Fill Out a Valid Oklahoma Wc 12 Template Access Form Here

Fill Out a Valid Oklahoma Wc 12 Template

The Oklahoma WC-12 form is a pivotal document for employers or insurance carriers aiming to request a rebate from the Workers’ Compensation Multiple Injury Trust Fund for payments made in a specific tax year. It facilitates the recapturing of two-thirds of the total payments made to the fund, provided that the form is filled out accurately and submitted within the designated time frame. Detailing the necessary financial and employer information, this form serves as a certified claim under penalty of perjury for a rebate.

To streamline the process of reclaiming a portion of your contributions to the fund, ensure the WC-12 form is completed correctly. Click the button below to begin your rebate request.

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In navigating the complexities of workers' compensation, employers and insurance carriers in Oklahoma find the WC-12 form to be a critical document. This form, officially revised in January 2014, serves as the rebate request for the Multiple Injury Trust Fund (MITF) for a specific tax year. It is designed for own risk employers or insurance carriers looking to obtain a rebate, which amounts to two-thirds of the total Multiple Injury Trust Fund payments made within the year. The document requires detailed information, including the Federal Employer’s Identification Number, address details, and banking information for processing the rebate. Furthermore, the form mandates an affirmation, under penalty of perjury, by an authorized representative of the employer or insurance carrier, confirming the accuracy and veracity of the information provided. The Oklahoma Tax Commission has been accepting these rebate applications since January 1, 2003, for assessments paid in the prior calendar year. However, there exists a deadline; applications for rebates must be submitted by May 31 of each year, or face a ten percent reduction in the rebate amount. No rebates are issued before July 1 of the rebate year, ensuring a meticulous review process by the Tax Commission. This scenario underscores the importance of timely and accurate submission of the WC-12 form to support financial management and compliance efforts for businesses involved.

Sample - 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

 

 

 

 

 

 

Document Information

Fact Name Description
Form Purpose The WC-12 form is designed for use by own risk employers or insurance carriers to request a rebate from the Oklahoma Worker’s Compensation Multiple Injury Trust Fund for the tax year.
Calculation of Rebate The rebate requested is calculated as two-thirds of the total payments made into the Multiple Injury Trust Fund.
Requirement for Submission The form requires detailed information, including the employer’s or insurance carrier’s identification, bank details, and a declaration signed under penalty of perjury.
Governing Law Starting January 1, 2003, the Oklahoma Tax Commission is responsible for processing rebate applications according to specified guidelines, with changes in application deadlines and rebate reductions enacted starting the calendar year of 2007.
Deadlines and Penalties Applications must be submitted by May 31 of each year to avoid a ten percent reduction in the rebate amount. Rebates are not issued until after July 1 each year.
Special Instructions for Calculation The instructions note the acceptable variance in the calculation of two-thirds, offering examples of rounding to the fourth decimal place.

Guide to Filling Out Oklahoma Wc 12

Filling out the Oklahoma WC-12 form is a necessary step for Own Risk Employers or Insurance Carriers looking to request a rebate from the Multiple Injury Trust Fund for the previous tax year. The process involves accurately providing details about the employer or carrier, calculating the rebate amount, and certifying the request under penalty of perjury. Follow these steps to ensure your form is correctly completed and submitted on time to avoid any reduction in the rebate amount.

  1. Gather necessary documents that contain the information about total payments made to the Multiple Injury Trust Fund in the specified tax year.
  2. Enter the legal name of the Own Risk Employer or Insurance Carrier in the designated space.
  3. Provide the Federal Employer’s Identification Number (FEIN) next to the employer or carrier's name.
  4. Fill in the street address, city, state, and zip code of the employer or carrier.
  5. Choose the type of bank account for receiving the rebate by checking either the "Checking" or "Savings" box, then enter the Bank Routing Number and Bank Account Number.
  6. In the section numbered 1, input the total amount of payments made to the Multiple Injury Trust Fund in the specified year.
  7. Calculate 2/3 of the amount entered in step 6 and record this figure in the section labeled "Rebate Requested (2/3 of Amount Entered on Line 1.)."
  8. Sign and date the form in the provided fields to certify the accuracy and completeness of the request. Make sure this is done by someone with the authority to represent the employer or carrier.
  9. Print the name and title of the individual who signed the form, and provide a contact telephone number.
  10. Review all entered information for accuracy and completeness before submission.
  11. Send the completed form to the Oklahoma Tax Commission, Account Maintenance Division at 2501 North Lincoln Blvd., Oklahoma City, OK 73194, ensuring it is received on or before May 31 to avoid a reduction in the rebate amount.

After submitting the WC-12 form, it will be processed by the Oklahoma Tax Commission. Only after July 1st of each year are rebates paid out. The Commission will verify the requested rebate amount, and adjustments may be made based on rounding or other variables indicated under the "Office Use Only" section. Applicants may receive confirmation or additional inquiries from the Commission during the review process. Timely and accurate submission of the WC-12 form ensures a smoother process in obtaining a rebate from the Multiple Injury Trust Fund.

Get Clarifications on Oklahoma Wc 12

  1. What is the WC-12 form used for in Oklahoma?

    The WC-12 form is specifically designed for own-risk employers or insurance carriers to request a rebate from the Oklahoma Workers’ Compensation Multiple Injury Trust Fund (MITF) for payments made into the fund within a given tax year. This is a critical financial process that allows eligible entities to recoup a portion of the assessments paid, underlining the form’s importance in managing workers' compensation costs effectively.

  2. Who is eligible to submit the WC-12 form for a rebate?

    Eligibility to submit the WC-12 form for a rebate is granted to “own risk employers” and insurance carriers. These entities must have made payments into the Multiple Injury Trust Fund in the previous calendar year to qualify for the rebate. It is essential that these submissions are accurately completed and authorized by a representative of the employer or carrier to ensure eligibility and compliance with Oklahoma law.

  3. How is the rebate amount calculated on the WC-12 form?

    The rebate amount requested on the WC-12 form is calculated as two-thirds (2/3) of the total Multiple Injury Trust Fund payments made by the employer or insurance carrier in the specified tax year. It's important for applicants to ensure this calculation is precise, as the form even makes a note regarding the specific decimal representation of two-thirds, indicating scrutiny in accuracy for rebate amounts.

  4. What is the deadline for submitting the WC-12 form to be eligible for the rebate?

    The deadline for submitting the WC-12 form for rebate eligibility is May 31 of each year for assessments paid concerning the previous calendar year. It's crucial for applicants to adhere to this deadline because submissions made after May 31 will incur a ten percent (10%) reduction in the rebate amount. This adds a layer of urgency for entities seeking to maximize their rebate potential.

  5. Where should the completed WC-12 form be mailed?

    The completed WC-12 form should be mailed to the Oklahoma Tax Commission, specifically to the attention of the Account Maintenance Division at 2501 North Lincoln Blvd., Oklahoma City, OK 73194. It is advised for applicants to confirm this address and any potential updates to the submission process to ensure timely and accurate delivery of their rebate request.

Common mistakes

Filling out the Oklahoma WC-12 form accurately is crucial to ensure eligible parties receive the correct rebate from the Workers’ Compensation Multiple Injury Trust Fund for tax purposes. However, certain mistakes are commonly made during this process. Understanding these errors can help avoid potential delays or reductions in the rebate amount.

  1. Incorrect Employer or Insurance Carrier Information: Not providing the exact name or entering an inaccurate Federal Employer’s Identification Number can lead to processing delays.
  2. Address Errors: Failing to include the complete street address, city, state, and zip code might result in the rebate application not reaching the intended destination or being processed correctly.
  3. Bank Account Details: Entering an incorrect bank routing number or bank account number can cause rebate funds to be sent to the wrong account, leading to significant delays in receiving the rebate.
  4. Selection of Account Type: Not clearly indicating whether the account is checking or savings can prevent the rebate from being deposited.
  5. Miscalculation of Rebate Amount: Incorrectly calculating 2/3 of the Total Multiple Injury Trust Fund Payments can lead to an incorrect rebate request. This is often due to using a decimal representation that is not precise.
  6. Signature Discrepancies: The signature of the authorized representative must be present. Failure to sign the form or discrepancies in the signature compared to records can invalidate the application.
  7. Late Submission: Submitting the form after May 31 of each year can result in a 10% reduction of the rebate amount, impacting the overall rebate received.

Avoiding these common mistakes requires careful review and precise entry of all required information on the form WC-12. Accurate and timely submissions ensure that eligible employers or insurance carriers can receive their rebates without unnecessary complications.

Documents used along the form

When managing workers' compensation claims in Oklahoma, particularly with regard to the Multiple Injury Trust Fund (MITF) represented by Form WC-12, it's important for businesses and insurance carriers to be aware of other key forms and documents that are frequently required in this context. These documents range from initial injury reporting to detailed employee claims and employer responses, each playing a critical role in the efficient and lawful handling of workers' compensation matters.

  • Form 3 – Employer’s First Notice of Injury: This form serves as the initial notice that an employer files when an employee is injured at work. It collects details about the injury and the employee involved.
  • Form 3A – Employer’s First Notice of Occupational Disease: Similar to Form 3, this version is specifically for occupational diseases, detailing the condition and the affected employee.
  • Form 2 – Employer’s Intent to Accept or Contest Claim: After receiving a claim, employers use this form to indicate whether they plan to accept or contest the employee’s workers' compensation claim.
  • Form 4 – Employee’s Claim for Compensation: Employees file this form to formally claim workers' compensation benefits following an injury or occupational disease.
  • Form 9 – Physician’s Report on Injury: A critical medical document where the treating physician details the employee's injury, treatment, and prognosis, which aids in the claims process.
  • Form 10 – Request for Temporary Total Disability or Permanent Partial Disability: This form is used by an employee or representative to request these specific types of disability benefits.
  • Form 13 – Employer’s Supplementary Notice of Injury: Employers use this form to update or provide additional information related to a previously reported injury or occupational disease.
  • Form 14 – Notice and Instruction to Employer for Oklahoma Workers’ Compensation Notice and Instruction Board: This document helps employers comply with requirements for posting notices about workers’ compensation rights and procedures in the workplace.
  • Settlement Agreement Form: When a workers' compensation claim is settled, this document outlines the terms of the settlement between the employer (or insurance carrier) and the employee.

Understanding and properly utilizing these forms ensures that both employers and employees navigate the workers' compensation claims process effectively. Providing clear, accurate information on each required document facilitates a more straightforward and fair resolution of claims, ultimately supporting the rights and recovery of injured workers in Oklahoma.

Similar forms

The Form WC-12 is similar to the IRS Form 941, Employer's Quarterly Federal Tax Return, because both forms involve reporting financial information to a governing entity for regulatory compliance. The IRS Form 941 requires employers to detail wages paid, taxes withheld from employees, and taxes owed to the government, aligning with the notion of reporting and compliance seen in WC-12's context of worker compensation rebate requests.

Another document resembling the Form WC-12 is the Form W-2, Wage and Tax Statement. The W-2 is used by employers to report wages paid to employees and the taxes withheld from them to the Social Security Administration. This form, like the WC-12, necessitates accurate financial reporting by an employer for the purpose of determining liabilities or benefits, in this case, social security and tax obligations.

The Form 1099-MISC, Miscellaneous Income, also shares similarities with the Oklahoma WC-12 form. The 1099-MISC is utilized for reporting payments made in the course of a trade or business to individuals not treated as employees (e.g., independent contractors). Both forms require detailed financial information to ensure proper administration of payments and compliance with tax laws.

Form I-9, Employment Eligibility Verification, though primarily focused on verifying the legal authority of employees to work in the United States, relates to WC-12 in its legal obligation aspect. Employers must accurately complete and retain Form I-9 for each individual they hire, akin to WC-12's requirement for employers to accurately report and request rebates related to workers’ compensation.

Form UI-3/40, Employer's Quarterly Unemployment Insurance Wage Report, used for reporting wages paid to employees for unemployment insurance purposes, is similar to WC-12. It necessitates the submission of accurate payroll information to a governmental agency, highlighting the theme of employer reporting responsibilities found in WC-12.

Oklahoma Form OW-8-ES, Estimated Tax Worksheet for Individuals, bears resemblance to WC-12 in that it involves calculation and reporting of owed amounts to the state, in this case, estimated personal income tax. While serving different purposes, both forms require individuals or entities to calculate and report figures relevant to state compliance.

The Federal FUTA Tax Form 940, Employer’s Annual Federal Unemployment (FUTA) Tax Return, is akin to WC-12 as it involves employers reporting on their financial obligations to a government agency. Form 940 specifically relates to unemployment taxes owed by employers, emphasizing statutory compliance and financial accuracy as seen with WC-12’s worker compensation rebate calculations.

Form DWC-1, Workers' Compensation Claim Form, is used by employees to file a claim for compensation for a work-related injury or illness. This document connects with WC-12 through the focus on workers' compensation, albeit from the perspective of initiating a claim rather than requesting a rebate.

The Form 5500, Annual Return/Report of Employee Benefit Plan, shares similarities with WC-12 in its role in ensuring compliance with government regulations on financial and other information related to employee benefit plans. Both forms are critical for transparency and adherence to regulatory standards affecting workplace compensation and benefits.

Last, the PD F-1048, Claim for Lost, Stolen, or Destroyed United States Savings Bonds, though not directly related to workers' compensation or tax reporting, is similar to WC-12 in the procedural sense. Both forms involve filing a claim with a government entity, requiring accurate information and documentation to support the claim—highlighting a broader theme of regulatory compliance and financial integrity.

Dos and Don'ts

When completing the Oklahoma WC-12 form, there are several best practices to ensure the process goes smoothly and correctly. Here’s a helpful guide on what you should and shouldn't do.

Things you should do:

  1. Verify all provided information: Make sure that all the details, such as the Federal Employer’s Identification Number, bank routing number, and account number, are accurate and current to avoid any delays in the rebate process.
  2. Calculate the rebate accurately: Ensure that you correctly calculate 2/3 of the total Multiple Injury Trust Fund Payments to request the right rebate amount. It's critical to use the correct calculation to prevent any discrepancies.
  3. Sign and date the form: The form requires the signature and printed name of the authorized representative of the employer or insurance carrier. Do not forget to sign and date the form to certify the information provided is accurate and complete.
  4. Check the deadline: Submit the form before the May 31st deadline to avoid a 10% reduction in your rebate. Timely submission ensures you receive the full eligible rebate amount.
  5. Keep a copy for your records: After submitting the form to the Oklahoma Tax Commission, ensure you retain a copy for your personal records. This can be helpful for future reference or in case any questions arise concerning your submission.

Things you shouldn't do:

  1. Leave sections blank: Do not skip any sections of the form. Incomplete forms may lead to delays in processing or denial of your rebate request.
  2. Estimate figures: Avoid guessing or estimating figures, especially when reporting the total Multiple Injury Trust Fund Payments and rebate amount. Accuracy is essential to the validity of your request.
  3. Use the wrong calculation: Do not deviate from using the 2/3 guideline for calculating your rebate, as variations can result in incorrect rebate amounts being requested.
  4. Ignore the bank account type: Make sure to specify whether your bank account is checking or savings. This simple but important detail ensures that the rebate is processed to the correct account.
  5. Submit outdated information: Refrain from using outdated or obsolete information, particularly concerning your banking details or contact information. Keeping your information current is crucial for ensuring the rebate is issued promptly and correctly.

Misconceptions

  • A common misconception is that the Oklahoma WC-12 form applies to all types of workers' compensation claims. However, it specifically pertains to rebate requests associated with payments made into the Multiple Injury Trust Fund for the previous tax year. This fund is unique as it addresses situations involving workers with pre-existing disabilities who experience subsequent workplace injuries.

  • Another misconception is that the rebate amount requested on the form is arbitrary. In reality, the form stipulates that the rebate amount should be two-thirds of the total Multiple Injury Trust Fund payments made, a calculation aimed at ensuring uniformity and fairness in the processing of these requests.

  • Some believe that the WC-12 form can be submitted at any time during the year. This is not the case, as the form clearly states applications for rebates for assessments paid pertaining to the previous calendar year must be accepted by the Oklahoma Tax Commission starting January 1, but a 10% reduction is applied if the application is not submitted by May 31 of each year. No rebates are processed before July 1.

  • There is a misconception that the exact percentage used for the rebate calculation (2/3) can be approximated without issue. The form's note regarding the “Difference in rounding” demonstrates a strict approach to the handling of this calculation, highlighting the need for accuracy and adherence to the specified two-thirds figure, not an approximation like .666 or .667.

  • Finally, many are under the impression that any employer or insurance carrier can request a rebate using the WC-12 form. It is essential to understand that the form is designed for use by “own risk” employers or insurance carriers, meaning entities that independently bear the financial risk of workers' compensation claims rather than those who are part of a pooled risk group.

Key takeaways

Filling out and using the Oklahoma WC-12 form involves a series of steps and important details that employers and insurance carriers must pay attention to. Here are key takeaways to help guide you through the process:

  1. Ensure you are eligible for rebates from the Multiple Injury Trust Fund (MITF) by verifying your status as an "own risk employer" or insurance carrier.
  2. Accurately report the total payments made to the MITF in the specified tax year, as this figure is crucial for determining your rebate amount.
  3. Understand that the rebate amount you can request is two-thirds of the total MITF payments you reported.
  4. Complete the form with careful attention to detail, including the accurate Federal Employer Identification Number (FEIN) and the correct banking information for rebate receipt.
  5. Be aware of the importance of signing the form as this certifies, under penalty of perjury, that the information is accurate and true, and confirms you are a duly authorized representative of the entity.
  6. Note the critical deadlines: Applications for rebates for the previous calendar year's assessments must be submitted by May 31st to avoid a penalty.
  7. Realize that a 10% reduction will apply to your rebate if your application is submitted after the May 31st deadline, starting with rebates for the calendar year 2007.
  8. Expect rebates to be processed and paid after July 1st of each year, aligning with the procedures set by the Oklahoma Tax Commission.
  9. Send your completed WC-12 form to the Oklahoma Tax Commission at the specified address, ensuring it reaches the Account Maintenance Division for processing.
  10. Pay attention to the possible differences in rounding when calculating your rebate amount to ensure consistency with state guidelines.

In essence, the WC-12 form is a critical document for employers and insurance carriers seeking a rebate from the Multiple Injury Trust Fund in Oklahoma. By carefully following the instructions and meeting the specified deadlines, parties can efficiently navigate the rebate process. Accurate completion and timely submission of the form guarantee a smoother transaction with the Oklahoma Tax Commission and help in recuperating a substantial portion of the funds paid into the MITF. Being diligent, detailed, and timely in handling the WC-12 form ensures that employers and carriers can benefit from the rebate system designed to support them.

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