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Claim Of Appeal To Appellate Division Form. This is a Rhode Island form and can be use in Workers Compensation Court Workers Comp.
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Tags: Claim Of Appeal To Appellate Division, Rhode Island Workers Comp, Workers Compensation Court
c
A
V
STATE OF RHODE ISLAND
PROVIDENCE,
AND PROVIDENCE
SC
PlANTATIONS
WORKERS'
vs
w.c.c.
COMPENSATION
COURT
No.
COURT
COUNTY .OF. . . . . . OF . .APPEAL . . . . .TO. . THE. . . APPELLATE
CLAIM
DIVISION
......... ..
... ........
.. ....
.......
:
Index No.
And now in the above-entitled
Saturdays,
cause, within five (5) days of the date of the entry of a decree, exclusive of
Sundays and holidays
of said decree on
of appeal to the Appellate
:
the
Division
Calendar No.
being aggrieved
hereby files :
and hereby requests a transcript
Plaintiff(s)
-against-
by the entry
claim
JUDICIAL SUBPOENA
of the testimony.
:
:
-Signature
of Attorney
for
the
appellant
:
Defendant(s)
:
......................................................
The estimated
cost of the transcript
of testimony
P~tomey's
in the sum of $
Name
has been paid
THE PEOPLE OF THE STATE OF NEW YORK
TO
The
Administrator
reasons
of
GREETINGS:
appeal,
together
with
the
transcript
of testimony
shall
be filed
on or
before
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court Date
Judge
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
The adjourned date, to testify and of appeal and a witness in this action on the part ofhereby extended
to
or time for filing reasons give evidence as the transcript of testimony is the
-
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
Judge
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.
Date
The
time
of
filing
reasons
of
Witness, Honorable
Court in
County,
appeal
and
the
transcript
of
testimony
time
for
filing
reasons
day of
Date
of appeal
and
the
transcript (Attorney must sign above and type name below)
of testimony
is hereby extended
Attorney(s) for
time
for
filing
reasons
to
, 20
Judge
The
extended
, one of the Justices of the
Judge
The
is hereby
of
appeal
and
the
transcript
of
to
Date
testimony
is hereby
extended
to
Office and P.O. Address
Judge
Date
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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