Verification (Application For Discrimination Benefits Pursuant To Labor Code Section 132a) | Pdf Fpdf Doc Docx | California

 California   Workers Comp   General 
Verification (Application For Discrimination Benefits Pursuant To Labor Code Section 132a) | Pdf Fpdf Doc Docx | California

Last updated: 5/30/2015

Verification (Application For Discrimination Benefits Pursuant To Labor Code Section 132a)

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Description

VERIFICATION. This form is used in California workers’ compensation proceedings to verify the accuracy of an application alleging discrimination by an employer. By signing this verification, the petitioner declares under penalty of perjury that they have read the Application for Discrimination Benefits filed under Labor Code section 132a and that its contents are true and correct to the best of their knowledge, except for matters stated on information or belief. The form includes space for the county, date, and place of execution and must be signed by a party to the action. www.FormsWorkflow.com

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