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Get and Sign Lien Affidavit Wcab Form
Foregoing is true and correct and that this affidavit was executed at
, California on
WCAB-003
Supplemental Page
Re: Resolution of Liens
Case No.
Lien Claimant
Nature and Date of Lien Resolution Efforts
Result
I declare under penalty of perjury that the foregoing is true and correct and that this affidavit was executed at
, California,...
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