10770.6 Verification To Filing Of Declaration Of Readiness By Or On Behalf Of Lien Claimant {10770.6} | Pdf Fpdf Doc Docx | California

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10770.6 Verification To Filing Of Declaration Of Readiness By Or On Behalf Of Lien Claimant {10770.6} | Pdf Fpdf Doc Docx | California

10770.6 Verification To Filing Of Declaration Of Readiness By Or On Behalf Of Lien Claimant {10770.6}

This is a California form that can be used for General within Workers Comp.

Alternate TextLast updated: 5/30/2015

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§10770.6. Verification to Filing of Declaration of Readiness By or on Behalf of Lien Claimant I declare under penalty of perjury under the laws of the State of California: (Check at least one box) that the underlying case has been resolved. that at least six months have elapsed from the date of injury and the injured worker has chosen not to proceed with his or her case. In determining that the injured worker has chosen not to proceed with his or her case, I have made a diligent search consisting of the following efforts (specify): s/s __________________ on __________________ Failure to attach the verification or an incorrect verification may be a basis for sanctions. No Declaration of Readiness to Proceed shall be filed for a lien under Labor Code section 4903(b) without an attached verification certifying under penalty of perjury either (1) that the underlying case has been resolved or (2) that at least six months have elapsed from the date of injury and the injured worker has chosen not to proceed with his or her case. The declarant shall make a diligent search to determine that the injured worker has chosen not to proceed with his or her case and the verification shall specify the efforts made in conducting the diligent search. A diligent search shall include contacting the injured worker, contacting the employer or carrier, or inquiring at the district office with appropriate venue pursuant to Labor Code section 5501.5(a)(1) or Labor Code section 5501.5(a)(2). American LegalNet, Inc. www.FormsWorkFlow.com

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