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Unemployment Compensation Notice Of Appeal To Missouri Court Of Appeals 8-C - Missouri
| Unemployment Compensation Notice Of Appeal To Missouri Court Of Appeals Form. This is a Missouri form and can be used in Eastern District Court Of Appeals Appellate Courts . |
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APPENDIX E FORM NO. 8-C WORKERS' COMPENSATION NOTICE OF APPEAL TO MISSOURI COURT OF APPEALS __________________ DISTRICT BEFORE THE LABOR AND INDUSTRIAL RELATIONS COMMISSION STATE OF MISSOURI ) ) ) ) Injury No.____________________________________ ) ) Appellate Court No.___________________________ ) Employer. ) ) Claimant, vs. Notice is hereby given that _______________________________ appeals to the Missouri Court of Appeals, _____________________ District. ___________________________________ Date notice of Appeal filed (to be filled in by Secretary of Commission) _____________________________________________ Signature of Attorney or Appellant (The appellant(s) must file the original notice of appeal and one copy for the Appellate Court with, and pay the docket fee required by court rule to, the secretary of the commission within the time specified by law. At the same time appellant must serve a copy of the notice of appeal on attorneys of record of all parties other than appellant(s), and on all parties not represented by an attorney. Proof of service shall be made on the original and copy to be filed with the commission. ) CASE INFORMATION TYPE NAME AND BAR ENROLLMENT NUMBER OF APPELLANT'S ATTORNEY _____________________________________ Street________________________________ City__________________________________ State_______________ Zip Code__________ Telephone____________________________ TYPE NAME OF APPELLANT _____________________________________ Street________________________________ City__________________________________ State_______________ Zip Code__________ Date of Commission Award or Decision: _____________________________________ (Attach copy of Commission Award or Decision) TYPE NAME AND BAR ENROLLMENT NUMBER OF RESPONDENT'S ATTORNEY *List additional respondents on page two of this form ________________________________________ Street___________________________________ City_____________________________________ State________________ Zip Code____________ Telephone_______________________________ TYPE NAMES OF Employee:_______________________________ Dependents:______________________________ Employer:________________________________ Insurer:__________________________________ Date and County of Accident:_________________ ________________________________________ ________________________________________ Second Injury Fund Involved: YES____ NO____ DIRECTIONS TO COMMISSION A copy of the notice of appeal and the docket fee shall be mailed forthwith to the clerk of the appellate court. The record on appeal shall be prepared and certified within such time as to enable timely filing by the appellant. PROOF OF SERVICE I have this day served a copy of this notice of appeal on each of the following persons at the address stated by __________________________ (ordinary mail, certified mail, personal service): _____________________________________________ Signature of Attorney or Appellant Dated: _______________________, 19____ 28 American LegalNet, Inc. www.FormsWorkFlow.com
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