Affidavit Of Defendant Re Resolution Of Liens

STATE OF CALIFORNIA WORKERS' COMPENSATION APPEALS BOARD Case No. Applicant, vs. AFFIDAVIT OF DEFENDANT RE: RESOLUTION OF LIENS Defendants. I, , am the attorney or representative for defendant in the above-entitled matter. I have made the following good faith efforts to resolve each of the Iiens in this case. List ALL lien claims below. Use supplemental pages as necessary. Lien Claimant Nature and Date of Lien Resolution Efforts Result I declare under penalty of perjury that the foregoing is true and correct and that this affidavit was executed at , California on , . 2002 © American LegalNet, Inc. Supplemental Page Re: Resolution of Liens Case No. Lien Claimant Nature and Date of Lien Resolution Efforts Result I declare under penalty of perjury that the foregoing is true and correct and that this affidavit was executed at California, on , . 2002 © American LegalNet, Inc.