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Writ Of Certiorari (Workers Comp) 116B - Minnesota
| Writ Of Certiorari (Workers Comp) Form. This is a Minnesota form and can be used in Appellate Law Statewide . |
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FORM 116B. WRIT OF CERTIORARI STATE OF MINNESOTA IN SUPREME COURT WRIT OF CERTIORARI CASE TITLE: Employee- Relator, vs. SUPREME COURT NUMBER: WORKERS' COMPENSATION COURT OF APPEALS NUMBER: DATE OF SERVICE OF NOTICE OF DECISION: WRITTEN Employer-Respondent, Insurer-Respondent. TO: The Workers' Compensation Court of Appeals: You are hereby ordered to return to the Supreme Court within 30 days from this date the record, exhibits and proceedings in the above-entitled matter so that this court may review the decision of the Workers' Compensation Court of Appeals. Copies of this writ and accompanying petition shall be served forthwith either personally or by mail upon the Secretary of the Workers' Compensation Court of Appeals and upon the Employer-Respondent(s) above-named or their attorney(s) at: ________________________________________________________________ ________________________________________________________________ (address) Proof of service shall be filed with the Clerk of the Appellate Courts. DATED: Clerk of Appellate Courts (Clerk's File Stamp) By: ____________________ Assistant Clerk American LegalNet, Inc. www.FormsWorkflow.com
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