Free 07-6112 - Alaska

ALASKA WORKERS COMPENSATION BOARD POUCH 7-019 ANCHORAGE, ALASKA 99510 ) ) ) ) ) Employee, ) ) ) ) vs. ) ) ) ) Employer. ) ) ) ) ________________________________________) To:

S U B P O E N A Case No. _______________

_______________________________________________________ _______________________________________________________ _______________________________________________________

You are commanded to appear and testify before the Alaska Workers Compensation Board on the ______________ day of _______________, 19 _____, at ______________. m., at _________________________________________________ __________________________________________________________________________. This subpoena is issued on the application of ________________________ __________________________________________________________________________. Alaska law requires you to appear. DATED at Juneau, Alaska, this ________day of ________________, 19 ___.

ALASKA WORKERS COMPENSATION BOARD

By _____________________________________

Form 07-6112 (formerly ADL 207) (Rev. 3/94)