STATE OF NEW MEXICO WORKERS COMPENSATION AD MINISTRATION _____________________________, WCA NO:_____________________ Worker, VS. _____________________________, and Employer, _____________________________, Insurer, JOINT WAIVER OF SERVICE OF PROCESS I, ________________________, appearing for the Worker & ________________________ appearing for the Employer/Insurer waive our right to the service of process of the _________________________________ in the above captioned cause at: ___________________________________ ___________________________________ ___________________________________ Pursuant to Rules of Civil Procedure for the District Courts of New Mexico Rule 1-004. ________________________ ________________________ Signature of the Worker Signature of the Employer/Insurer waiving service of process waiving service of process ________________________ ________________________ Relationship to Entity/ Relationship to Entity/ Authority to Receive Authority to Receive Service of Process Service of Process ________________________ ________________________ Date of Signature Date of Signature