What is the WCAB CA Form 10214 e Ver1 9 08 08 DIR?

The WCAB CA Form 10214 e Ver1 9 08 08 DIR is a specific form used for workers' compensation claims in California. It is essential for both employers and employees to complete this form accurately to ensure compliance with California's workers' compensation regulations. Using airSlate SignNow, you can easily fill out and eSign this form securely.

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Wcab Ca Form 10214 E Ver1 9 08 08 Dir

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STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF W ORKERS' COMPENSATION WORKERS' COMPENSATION APPEALS BOARD Case No. Applicant VS. Defendants Petition for Appointment of Guardian ad Litem and Trustee As a result of an alleged industrial injury on, to Injured Employee while employed by Employer benefits are claimed by the following minor(s)/incompetent(s): Strike inapplicable matter NameDate of Birth The minor(s)/incompetent(s) require a Guardian ad Litem and Trustee to prosecute the claim and to receive Strike inapplicable matter and receipt for any benefits awarded or voluntarily furnished. The W orkers' Compensation Appeals Board is requested to appoint Relationship if any ,, as Guardian ad Litem and Trustee. * who has legal custody of, and is legally responsible for the support of the minor(s). ( * Strike if not applicable.) W e hereby join in the above request. NOTE: Consent must be signed by all minors over 14 years of age and by all adults with sufficient capacity to form an intelligent preference. Date , Petitioner Address Attorney for Petitioner Address and telephone number DIA W CAB FORM 8 (REV. 10-90)WCAB-8

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