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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. Applicant vs. SUBSTITUTION OF ATTORNEYS Defendant(s) _____ appoints _____ as his attorney in the above entitled case, in the place of _____ who respectively consent hereto.

WORKERS’ COMPENSATION APPEALS BOARD Author: daniela giomi Created Date: 10/5/2010 1:52:25 PM ...

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