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Order Granting Payment Of Lien Claim WC-905 - California
| Order Granting Payment Of Lien Claim Form. This is a California form and can be used in General Workers Comp . |
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STATE OF CALIFORNIA WORKERS' COMPENSATION APPEALS BOARD Case No. Applicant, ORDER GRANTING PAYMENT OF vs. LIEN CLAIM Defendants. The parties have reached an agreement concerning payment of the lien claim of (lien claimant), in the amount of $ in full satisfaction of said lien. . The defendants agree to pay lien claimant $ Date Lien Claimant Date Defendant ORDER IT IS HEREBY ORDERED THAT defendants, pay to lien claimant, the sum of $ in full satisfaction of said lien. WORKERS' COMPENSATION JUDGE Dated: Service by Hand on parties on this date. Mail By: WC-905 2002 © American LegalNet, Inc.
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