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REQUEST FOR SPECIFIC FINDINGS OF FACT AND CONCLUSION OF LAW

In the Matter of the Workers' Compensation Claim of: 



Vs




WC #-###-###-##
A. Request for Specific Findings of Fact and Conclusions of Law
The party dissatisfied by the Summary Order is the:

It is requested that a full order containing specific findings of fact and conclusions of law pursuant to Section 8-43-215, C.R.S..

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. 










C. Certificate of Mailing

I hereby certify that I mailed or delivered true and correct copies of Request for Specific Findings

of Fact and Conclusion of Law for Transcript to all parties at the addresses shown below.

Opposing Party 1 or their Representative









#####

###-###-####


Opposing Party 2 or their Representative









#####

###-###-####


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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