Contact Registration Form | Pdf Fpdf Doc Docx | Florida

 Florida   Workers Comp 
Contact Registration Form | Pdf Fpdf Doc Docx | Florida

Last updated: 5/31/2023

Contact Registration Form

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Description

CONTACT REGISTRATION FORM. This form is used for registration with the Office of Judges of Compensation Claims (OJCC) in Florida to provide the necessary information for the publication of registered employers, carriers, and third-party administrators in the e-JCC system. The form requires the submission of business information, including the business name, type (employer, carrier, or third-party administrator), business email address for receiving litigation-related communications, U.S. mail address, and business phone number for OJCC contact. The form must be submitted either by email or mail to the OJCC. The form references the requirement for employers, self-insurers, third-party administrators, and carriers to register a single, general delivery email address with the OJCC for electronic document receipt, along with a U.S. mail address and telephone number. The registered companies and their email addresses are maintained in the e-JCC system, and it is the responsibility of each company to keep the email address updated. The form also includes references to relevant sections of the Florida Administrative Code and the laws implemented by the OJCC. www.FormsWorkflow.com

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