Get 12be Board Form Online

The 12be Board Form Online is an essential document for individuals participating in the Camogie Personal Accident Insurance Scheme. This guide provides clear, step-by-step instructions to help you navigate the online filling of the form accurately and efficiently.

Follow the steps to complete the form successfully.

1. Click ‘Get Form’ button to access the online document and open it in your preferred editor.
2. Begin with Section A, which must be completed in all cases. Fill in your name, address, date of birth, and details about your club. Ensure you also specify your contact number and employment status accurately.
3. In Section A, provide your medical insurance details. Indicate the medical insurance coverage you possess, if any, and list any other relevant insurance information.
4. Proceed to indicate the nature of your claim in Section A. You will need to check the appropriate boxes for the type of injury or loss of wages you are claiming.
5. Next, move to Section B where you will enter the date and nature of your injury, specify where the injury occurred, and indicate if you were wearing protective headgear at the time of the incident.
6. If claiming loss of wages, proceed to Section C for self-employed claimants. Provide your business details, amount of average weekly net income, and reason for your loss of income.
7. Section D is to be filled by your employer. Ensure they provide their details, the employee's details, reason for wage loss, and append necessary payslips or letters confirming details.
8. In Section E, complete details pertaining to Social Welfare benefits if applicable. This section requires confirmation of any benefits you received during your injury.
9. For medical certification, Section F must be filled out by the medical professional who treated you. Ensure they provide accurate diagnosis details and treatment information.
10. Finally, complete Section G to confirm your statements and consent to share your information as required. Ensure necessary signatures are obtained, including from your club secretary.
11. Once all sections are completed, you can save the changes, download a copy, print it, or share it as required.

Start filling out your 12be Board Form Online today to ensure your claim is processed efficiently.