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Request for Dismissal WCAB-43A - California
|Request for Dismissal Form. This is a California form and can be used in General Workers Comp .||
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STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS WORKERS' COMPENSATION APPEALS BOARD Case No. Applicant (Employee) vs. Request for Dismissal Defendants The dismissed without prejudice. above named hereby requests that this case be DATED: DIA WCAB FORM 43 (REV. 3-90) 2002 © American LegalNet, Inc.