COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.State of ConnecticutCalendar No.Workers' Compensation CommissionJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)Education Services Order FormPleasesendtheitem(s)markedbelowto:NameTelephone No. (). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .PositionOrganizationTHE PEOPLE OF THE STATE OF NEW YORK TOAddressCityStateZipGREETINGS:Pleasemarktheitem(s)belowwhichyouwouldliketoreceive,FREEofcharge:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,Literature:located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in room Information Packet (overview of workers' comp; includes a 30C claim form) Pocket Guide to Workers' Compensation English Polish Portuguese Spanish Bulletin No. 44 (WC Act, Related Statutes, Regulations & more) Bulletin No. 44 Supplement (Annotations to CRB Opinions) A Guide to 1996 Workers' Compensation Reform Legislation A Guide to 1995 Workers' Compensation Reform Legislation Summary of 1993 Workers' Compensation Law ChangesYour 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., one of the Justices of theCourt in Witness, Honorableday of, 20 County,Subscriptions: Please add me to the ISSUES Newsletter Mailing List(Attorney must sign above and type name below) Please add me to the following Chairman's Mailing List: Attorney Medical PractitionerAttorney(s) for Insurance UnionOffice and P.O. AddressVideotapes: The Physician's Role in Workers' Compensation(video & booklet for medical practitioners)Telephone No.: Facsimile No.: E-Mail Address:Mail this Order Form to:Mobile Tel. No.:Workers' Compensation Commission, Education Services, Capitol Place-4th Floor, 21 Oak Street, Hartford, CT 06106-8011American LegalNet, Inc. www.USCourtForms.com
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