New Mexico > Workers Compensation
Request For Setting (Application To Workers Compensation Judge) - New Mexico
| Request For Setting (Application To Workers Compensation Judge) Form. This is a New Mexico form and can be used in Workers Compensation . |
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STATE OF NEW MEXICO WORKERS' COMPENSATION ADMINISTRATION __________________________________________________, Worker, v. __________________________________________________, and __________________________________________________, Employer/Insurer. WCA No.:____________ REQUEST FOR SETTING 1. 2. WCA Judge assigned:_________________________________________________________________ Are any other hearings currently set? ____Yes ____No If yes, please indicate the date of the hearing:_______________________________________________ Specific matter to be heard:_____________________________________________________________ Time required for hearing:______________________________________________________________ Names/addresses/phone & fax of all counsel/parties pro se entitled to notice: _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ 3. 4. 5. NOTICE OF HEARING This matter will be heard before Judge ____________________________on________________________, 20_____, at ________a.m./p.m. with_________ hours/minutes allocated for hearing at: (_____) WCA Office or (_____) 2410 Centre Ave SE Albuquerque, NM 87106 (505) 841-6000 ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ __________________________________________________ By: Calendar Clerk Notice Mailed________________________, 20_____, by________________________________________ Counsel are expected to appear: (___) in person (___) by telephone conference call. STAMPED ENVELOPES FOR ALL PARTIES MUST BE SUBMITTED WITH REQUEST 11.4.4.9.18.2.K NMAC American LegalNet, Inc. www.FormsWorkFlow.com
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