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Get CA WCAB-003

List ALL lien claims below. Use supplemental pages as necessary. 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 on WCAB-003 Supplemental Page Re Resolution of Liens. STATE OF CALIFORNIA WORKERS COMPENSATION APPEALS BOARD Case No* Applicant vs. DECLARATION OF DEFENDANT RE RESOLUTION OF LIENS Defendants. am the attorney or representative for defendant I in t.

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