STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS WORKERS' COMPENSATION APPEALS BOARD Case No. Applicant vs. NOTICE OF INTENTION TO Defendant IT APPEARING THAT NOTICE IS HEREBY GIVEN that days after service hereof unless Good Cause to the contrary is shown in writing within said time. WORKERS' COMPENSATION JUDGE Dated Service by mail on parties as shown on Official Address Record effected on above date By: DIA WCAB FORM 29 (REV. 8-85) 2002 © American LegalNet, Inc.