Joint Waiver Of Disqualification Form. This is a New Mexico form and can be use in Workers Compensation.
Tags: Joint Waiver Of Disqualification, New Mexico Workers Compensation,
COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : STATE OF NEW MEXICO JUDICIAL SUBPOENA Plaintiff(s) WORKERS’ COMPENSATION ADMINISTRATION -against- _____________________________, Worker, : : WCA NO:_____________________ : Defendant(s) VS. : ...................................................... _____________________________, and Employer, THE PEOPLE OF THE STATE OF NEW YORK _____________________________, Insurer, TO GREETINGS: JOINT WAIVER OF DISQUALIFICATION WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before _______________________, appearing for the Worker, and ____________________________, , the Honorable at the Court located at County of inappearing for theon the room , Employer/Insurer jointly waive the right to disqualify a the day of , 20 , at o'clock in judge in the above any recessed noon, and at or adjourned date, to testify and give evidence as a witness in this action on the part of the captioned cause as provided under New Mexico Workers’Compensation Administration Rule 220.127.116.11.3. failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Your the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. _____________________________ Witness, Honorable Counsel Court in for Worker/Pro Se County, day of ____________________________________ , one of the Justices of the Counsel for Employer , 20 ______________________________ ____________________________________ ______________________________ ____________________________________ ______________________________ ____________________________________ Attorney(s) for (Attorney must sign above and type name below) Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com