Last updated: 10/4/2023
Summons For Workers Compensation Complaint
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Description
STATE OF NEW MEXICO WORKERS222 COMPENSATION ADMINISTRATION , WCA No.: Worker, v. , and , Employer/Insurer. SUMMONS FOR WORKERS222 COMPENSATION COMPLAINT TO: GREETINGS: You are directed to serve a written response to the Workers222 Compensation Complaint not less than five (5) days prior to the mediation conference, and file the same, as provided by law. You are notified that, unless you serve and file a responsive pleading, the filing party may apply to the Workers222 Compensation Administration for the relief demanded in the Workers222 Compensation Complaint. Worker or filing party's representative: Address of Worker or filing party's representative: WITNESSED AND SEALED BY THE CLERK OF THE WCA Rev. 1/1 American LegalNet, Inc. www.FormsWorkFlow.com
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