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Fill and Sign the New Mexico Compensation 497319883 Form

Fill and Sign the New Mexico Compensation 497319883 Form

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Open the document and fill out all its fields.
Apply your legally-binding eSignature.
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STATE OF NEW MEXICO WORKERS’ COMPENSATION ADMINISTRATION _________________________________________________, WCA No.:__________________ Worker, v. _________________________________________________, and _________________________________________________, Employer/Insurer. ________SUBPOENA OR________SUBPOENA DUCES TECUM TO: _____________________________________ _____________________________________ _____________________________________ GREETINGS : You are commanded to appear, under penalty of law, on ________________________________________ at ______________________________________.m. before the Workers’ Compensation Administration at _____________________________________________________________________________________, [Address where adjudication hearing is set] New Mexico, to testify in the above-entitled action on behalf of the ________________________________ [FOR SUBPOENA DUCES TECUM] You are further directed, under penalty of law, to bring the items described with you to the hearing for inspection: ___________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ WITNESSED & SEALED BY CLERK OF THE WCA (SEAL) By: ___________________________________________ Date: __________________________________________ Worker/Attorney/Representative: ________________________________ Address: ________________________________ City/State/Zip: ________________________________ Telephone: (___)____________________________ 11.4.4.9.18.2.J NMAC

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