Transcription of STATE OF CALIFORNIA DEPARTMENT OF …
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STATE OF CALIFORNIA DEPARTMENT OF …
Where no application has been filed for injuries on or afterJanuary 1, 1990 and before January 1, 1994, subpoena willbe valid without a case number, but subpoena must be servedon claimant and employer and/or insurance carrier. STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONSDIVISION OF WORKERS' COMPENSATIONWORKERS' COMPENSATION APPEALS BOARDCase No.(IF APPLICATION HAS BEEN FILED, CASE NUMBERMUST BE INDICATED REGUARDLESS OF DATE OF INJURY.)Claimant/Applicant,SUBPOENA DUCES TECUMvs.(When records are mailed, identify them by using abovecase number or attaching a copy of subpoena.)Employer/Insurance People of the STATE of CALIFORNIA Send Greetings to:WE COMMAND YOU to appear beforeaton theM, to testify in the aboveentitled matter and to bring with you and produce the following described documents, papers, books and failure to attend as required, you may be deemed guilty of a contempt and liable to pay to the parties aggrieved all losses anddamages sustained thereby and forfeit one hundred dollars in addition theretoThis subpoena is issued at the request of the person making the declaration on the reverse hereof, or on the copy which is servedherewith.
DECLARATION FOR SUBPOENA DUCES TECUM. Case No. STATE OF CALIFORNIA, County of The undersigned states: That he /she is (one of) the attorney(s) of record / representative(s) for the applicant / defendant in the action captioned
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