Florida > Workers Comp
Certification Of Counsel For Relief From Paying Filing Fee - Florida
| Certification Of Counsel For Relief From Paying Filing Fee Form. This is a Florida form and can be used in Workers Comp . |
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STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS OFFICE OF THE JUDGES OF COMPENSATION CLAIMS , ) (Employee) ) Claimant, ) ) vs. OJCC Case No. ) , ) Date of Accident: (Employer) ) Employer/Carrier. ) ______________________________________) CERTIFICATION OF COUNSEL FOR RELIEF FROM PAYING FILING FEE Pursuant to Sections 57.081(1) and 440.25(5), Florida Statutes, and Rule 9.180(g)(2), Florida Rules of Appellate Procedure, the undersigned attorney for __________________ ("Appellant"), certifies that: 1. I have investigated Appellants financial condition and found Appellant to be insolvent. 2. I have investigated the nature of Appellants position and believes it to be meritorious as a matter of law. 3. I have not been paid or promised payment of a fee or other remuneration except for the amount, if any, ultimately approved by the judge of compensation claims to be paid by the employer/carrier if such entitlement is determined by the court. Respectfully submitted, ___________________________________ (Attorneys Name) (Attorneys Address and Bar number) Counsel for Appellant American LegalNet, Inc. www.USCourtForms.com
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