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WORKERS’ COMPENSATION APPEALS BOARD

_____ _____ hereby substitutes and _____ _____ _____ _____ _____ STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF WORKERS COMPENSATION WORKERS COMPENSATION APPEALS BOARD Case No.

SUBSTITUTION OF ATTORNEYS _____ appoints _____ astorney his at in the. above‐entitled case, in the place of _____ who respectively consent hereto. A copy has been served on all parties or their attorneys where they have attorneys. Dated _____. Copies have been served on: ...

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  Appeal, Board, Compensation, Worker, Substitution, Workers compensation appeals board

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