Pre-Trial Conference Statement
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Pre-Trial Conference Statement Form. This is a California form and can be use in General Workers Comp.
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Tags: Pre-Trial Conference Statement, DWC-CA 10253.1, California Workers Comp, General
STATE OF CALIFORNIA
DEPARTMENT OF INDUSTRIAL RELATIONS
WORKERS’ COMPENSATION APPEALS BOARD
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BOX BELOW TO BE COMPLETED ONLY BY WORKERS’ COMPENSATION JUDGE
DISPOSITION: SET FOR REGULAR HEARING:
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SERVICE AS ORDERED ON PAGE 4
WORKERS’ COMPENSATION
ADMINISTRATIVE LAW JUDGE
DWC CA form 10253.1 (Rev 9/2010)
American LegalNet, Inc.
www.FormsWorkFlow.com
PRE-TRIAL CONFERENCE STATEMENT
CASE NO.
STIPULATIONS
THE FOLLOWING FACTS ARE ADMITTED:
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