Expedited Settlement Conference Information Sheet
Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Expedited Settlement Conference Information Sheet Form. This is a California form and can be use in General Workers Comp.
Loading PDF...
Tags: Expedited Settlement Conference Information Sheet, California Workers Comp, General
STATE OF CALIFORNIA , Governor DEPARTMENT OF INDUSTRIAL RELATIONSDIVISION OF WORKERS' COMPENSATION Workers' Compensation Appeals Board303 West Third Street, Room 400San Bernardino, California 92401-1888TEL: (714) 383-4341EXPEDITED SETTLEMENT CONFERENCEINFORMATION SHEETDATE CALLED:CONF. DATE OF: FRIDAY, @ 1:30 P.M.CASE NAME:SS #:CASE NOS.:------------------------------------------------------------------------------------------------------------------------------------ON THOSE CASES WHERE NEW FILES ARE TO BE PREPAREDDOI:PART(S) OF BODY:APPL. ATTY OF RECORD:SAME DEFENDANT EMPLOYER: YESIF NO: NAME AND ADDRESS OF NEW EMPLOYER:SAME DEFENDANT CARRIER? YESIF NO: NAME AND ADDRESS OF NEW CARRIER: NO NO American LegalNet, Inc. www.FormsWorkFlow.com
