STATE OF CALIFORNIA DIVISION OF WORKERS' COMPENSATION REQUEST FOR WALK-THROUGH Declarations of Readiness ONLY Please Complete This Form - Files Will Not Be Pulled If Request Form Is Incomplete. Please Note: FIVE REQUESTS PER OFFICE DAILY CASE NAME: CASE NUMBER(s): Attorney/Firm requesting file: Address: Telephone: Dates unable to appear: I acknowledge that I agree to serve the attached document(s) and Notice of Hearing forthwith on all parties shown on the Official Address Record along with a proof of service. I will maintain the proof of service and will not file it with the W.C.A.B. unless a dispute arises regarding service of the document. Signature: Date: To be completed by the calendar clerk: Type: Date: Time: Judge: Copy American LegalNet, Inc. www.USCourtForms.com