Ohcwa form 14 2025

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The document is an application form for dental treatment and consent at the Oral Health Centre of Western Australia (OHCWA). It requires personal information from the patient, including details about their eligibility for subsidised dental treatment based on their Centrelink benefits. The form includes sections for customer consent to access Centrelink information and outlines requirements for various benefit holders. Completion of both customer and income declarations is mandatory for treatment eligibility.

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What is the NCCI risk identification number?

What is a Risk ID? The Risk ID is a nine-digit numeric code assigned by NCCI to uniquely identify the insureds that are subject to interstate or intrastate experience rating. If your state does not use NCCI, there is an equivalent number provided by your specific states WC Bureau.

What is OSC Form 14?

The OSC Form 14 is a disclosure form filed by certain companies when they make certain public offerings of securities. Companies that must file the OSC Form 14 include non-reporting issuers, reporting issuers that are not reporting issuers in any other jurisdiction, and investment funds.

Where to send erm-14?

To submit the ERM-14 Form, you have several options: Email it to customer service at customer service@ncci.com, fax it to 561-893-1191, or send it via US Mail to NCCI at 901 Peninsula Corporate Circle, Boca Raton, FL 33487-1362. Ensure that all required documents are attached before submission.

What is the purpose of an ERM-14?

The ERM-14 form is used to request ownership information and may be used in a variety of instances, including when there has been a change in ownership, when an entity needs to be added later or when multiple entities need to be considered for combinability.

Who fills out an ERM-14?

The ERM-14 is a confidential form completed by the insured and submitted to the NCCI for the purpose of assisting the various workers compensation bureaus to verify coverage and determine combinability of entities as it relates to premium calculation.

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