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Petition For Writ Of Certiorari (Workers Comp) 116A - Minnesota
| Petition For Writ Of Certiorari (Workers Comp) Form. This is a Minnesota form and can be used in Appellate Law Statewide . |
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FORM 116A. PETITION FOR WRIT OF CERTIORARI STATE OF MINNESOTA IN SUPREME COURT CASE TITLE: PETITION FOR WRIT OF CERTIORARI Employee- Relator, SUPREME COURT NUMBER: WORKERS' COMPENSATION COURT OF APPEALS NUMBER: vs. DATE OF SERVICE OF NOTICE OF DECISION: WRITTEN Employer- Respondent, Insurer-Respondent. TO: The Supreme Court of the State of Minnesota: The above-named relator hereby petitions the Supreme Court for a Writ of Certiorari to review a decision of the Workers' Compensation Court of Appeals, upon the grounds that it is not in conformity with the terms of the Workers' Compensation Act and is unwarranted by the evidence. DATED: _________________________________ Attorney for Employee-Relator _________________________________ _________________________________ Address _________________________________ SIGNATURE _________________________________ Registration License Number _________________________________ Telephone Number American LegalNet, Inc. www.FormsWorkflow.com (The procedure for obtaining a writ of certiorari from the Supreme Court is set forth in RCAP 116. The rule prescribes the subject matter of writs in the Supreme Court, contents of the petition, bond or security, filing and fees, and requirements for service. Two copies of a completed statement of the case must accompany the petition.) American LegalNet, Inc. www.FormsWorkflow.com
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