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RESPONSE TO APPLICATION FOR HEARING

Please Note: If this is for a Worker's Compensation matter and you have a pending pre-hearing conference before the Division of Worker's Compensation, you should file any procedural motions with DoWC at the following location: 633 17th Street, 4th Floor, Denver, CO 80202




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WC #-###-###-##
Application for Hearing

Date of Application for Hearing

APPLICATION FOR HEARING


Name of Party
In addition to the issues marked on the Application for Hearing, the following issues shall be considered at the hearing:










Witnesses to be called at the hearing or by deposition (List names and addresses)







Signature
Please type your name in the box below.  By typing your name, you certify this information is accurate and certify that this will act as your binding electronic signature. 











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Certificate of Mailing

I hereby certify that I mailed or delivered the original of the  for Response to Application for Hearing to all parties at the addresses shown below (A claimant must provide a copy to the employer and the insurer, or their attorney):

Opposing Party 1 or their Representative









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Opposing Party 2 or their Representative









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Please type your name in the box below.  By typing your name, you certify this information is accurate and certify that this will act as your binding electronic signature. 


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