Waiver Of Disqualification Form. This is a New Mexico form and can be use in Workers Compensation.
Tags: 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: 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/Employer/Insurer waive the right to , the Honorable at the Court located at County of indisqualify a judge in the above captioned cause20 provided under Newin the room , on the day of , as , at o'clock Mexico Workers’ at any recessed noon, and or adjourned date, to testify and give evidence as a witness in this action on the part of the Compensation Administration Rule 4.4.1 2.2.3. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to 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. Counsel for Worker/Pro Se Counsel for Employer Witness, Honorable ______________________________ Court in County, day of , one of the Justices of the ____________________________________ , 20 ______________________________ ____________________________________ ______________________________ ____________________________________ (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com