Verification (Petition For Benefits For Serious And Willful Misconduct Of Employer) | Pdf Fpdf Doc Docx | California

 California   Workers Comp   General 
Verification (Petition For Benefits For Serious And Willful Misconduct Of Employer) | Pdf Fpdf Doc Docx | California

Last updated: 5/30/2015

Verification (Petition For Benefits For Serious And Willful Misconduct Of Employer)

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Description

VERIFICATION. This form is used in California workers’ compensation proceedings to verify the accuracy of a petition filed under Labor Code section 4553. By signing this verification, the petitioner declares under penalty of perjury that they have read the Petition for Benefits for Serious and Willful Misconduct of Employer 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 spaces for the county, date, and place of execution and must be signed by the petitioner. www.FormsWorkflow.com

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