Expedited Settlement Conference Information Sheet | Pdf Fpdf Docx | California

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Expedited Settlement Conference Information Sheet | Pdf Fpdf Docx | California

Expedited Settlement Conference Information Sheet

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

Alternate TextLast updated: 3/9/2018

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Description

STATE OF CALIFORNIA , Governor DEPARTMENT OF INDUSTRIAL RELATIONSDIVISION OF WORKERS' COMPENSATION Workers' Compensation Appeals Board303 West Third Street, Room 400San Bernardino, California 92401-1888TEL: (714) 383-4341EXPEDITED SETTLEMENT CONFERENCEINFORMATION SHEETDATE CALLED:CONF. DATE OF: FRIDAY, @ 1:30 P.M.CASE NAME:SS #:CASE NOS.:------------------------------------------------------------------------------------------------------------------------------------ON THOSE CASES WHERE NEW FILES ARE TO BE PREPAREDDOI:PART(S) OF BODY:APPL. ATTY OF RECORD:SAME DEFENDANT EMPLOYER: YESIF NO: NAME AND ADDRESS OF NEW EMPLOYER:SAME DEFENDANT CARRIER? YESIF NO: NAME AND ADDRESS OF NEW CARRIER: NO NO American LegalNet, Inc. www.FormsWorkFlow.com

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