Colorado > Workers Comp
Entry Of Appearance WC6 - Colorado
| Entry Of Appearance Form. This is a Colorado form and can be used in Workers Comp . |
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COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT Division of Workers' Compensation 633 17th St., Suite 400 Denver, CO 80202-3660 ENTRY OF APPEARANCE Claimant Workers' Compensation Number Employer Date of Injury Insurer Claimant Social Security Number You are hereby notified that the undersigned attorney is entering his/her appearance in the abovecaptioned matter. I am representing the following client. (1) (2) (3) (4) (5) Claimant Carrier Dependent Employer Other (Name of party) (Name of party) (Name of party) (Name of party) Attorney (print name) Attorney Registration Number Office Code Address City State Zip Code Phone Attorney Signature WC6 Rev 09/06 American LegalNet, Inc. www.FormsWorkflow.com
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