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124.34 Order / IDS Form

What is it used for?

This form is used to inform an employee of a disciplinary action and/or a non-disciplinary involuntary disability separation.

Examples include:

  • Order of Removal
  • Reduction
  • Suspension
  • Fine
  • Involuntary Disability Separation

Who uses this form?

This form is completed by the employer.

How to complete the form.

Instructions and a checklist on how to complete the O.R.C. 124.34 Order/Order of Involuntary Disability Separation (ADM 4055) form are provided when you download the form. If you have difficulty downloading the form, please contact SPBR at (614) 466-7046.