(as of 2/8/2008)
(Note: if the screenshot is not clear, you may need to single click once or twice on the screen shot to ZOOM it so that it is clear)
Court forms screen shot 3 (dual monitor support)
A1-Law Current Form List - All Forms (not categorized)
10408 1. Copy Service Order Form - General 10021 4906 G Form 10650 A1-Law / Letterhead / Starter Set 10657 A1-Law Closing with cc's (English) 10655 A1-Law Closing without cc's (English) 10656 A1-Law Closing without cc's (Spanish) 10666 A1-Law General Petition 10654 A1-Law Opening to Anyone 10652 A1-Law Opening to Client 10653 A1-Law Opening to Client / Spanish 10667 A1-Law Pleading2 Overlay File 10651 A1-Law WC Caption 10420 AAA Copy Service 10523 Affidavit of Defendant Re: Resolution of Liens 10079 Answer 10022 Answer 1/1/90 - 1/1/94 10004 APP-DEF SWITCH CODES 10025 Application Death 10024 Application 1/1/90-1/1/94 10026 Application Death 1/1/90-1/1/94 10023 Application for Adjudication 10251 Application for Order for Publication - Los Angeles 10520 Application for Subsequent Injuries Fund Benefits 10029 Arbitration Submittal Orders WC33 10028 Arbitration Submittal WC32A 10027 Attorney Client Agreement 10404 Attorney Diversified Services - Order Form 10207 Audit Referral Form 10701 Bankruptcy - Declaration - F4001-1.DEC 10703 Bankruptcy - Notice of Motion - F4001-1M.NA 10702 Bankruptcy - Order Granting Motion - F4001-10.NA 10033 C & R WC15 10517 C & R WC15 (Pre 2005) 10034 C & R Dependency WC16 10036 C & R Social Security Form 10035 C & R Third Party WC17 10406 Calcomp Legal Reproduction Services - Order Form 10509 Case Information Sheet - Form VN010 10401 Castle Photocopy Service - Order Form 10030 Change of Address WC001 10402 CIGA Photocopy Service - Order Form 10314 Civil Abstract of Judgment (EJ-001) 10361 Civil Acknowledgment of Satisfaction of Judgment (EJ-100) 10356 Civil ADR-102 Request for Trial De Novo After Judicial Arbitration (1/2007) 10328 Civil Answer--Personal injury, Property Damage, Wrongful Death (PLD-PI-003, 1/2007) 10347 Civil App & Order to Produce Statement of Assets & Appear for Exam (SC-134) 10342 Civil Application for Waiver of Court Fees and Costs (982(a)(17)) 10338 Civil Blank Attachment 10316 Civil Case Cover Sheet (CM-010) 10253 Civil Case Cover Sheet - Los Angeles 10321 Civil Case Cover Sheet Addendum & Statement of Location 10320 Civil Case Management Statement (CM-110, 1/2007) 10322 Civil Cause of Action - General Negligence 10325 Civil Cause of Action - Intentional Tort 982.1(4) 10319 Civil Cause of Action - Motor Vehicle 10323 Civil Cause of Action - Premises Liability 10324 Civil Cause of Action - Products Liability 10357 Civil Cause of Action-Breach of Contract (PLD-C-001(1), 1/2007) 10358 Civil Cause of Action-Common Counts (PLD-C-001(2), 1/2007) 10318 Civil Complaint - PI, Prop Damage, Wrongful Death 10327 Civil Cross Complaint - Personal Injury, Property Damage, Wrongful Death (PLD-PI-002, 1/2007) 10360 Civil Deposition Subpoena, Personal Appearance & Production of Docs (SUBP-020) 10349 Civil DISC-001 1/1/2007 Form Interrogatories-General 10350 Civil DISC-002 1/1/2007 Form Interrogatories-Employment Law 10351 Civil DISC-003 1/1/2007 Form Interrogatories-Unlawful Detainer 10352 Civil DISC-004 1/1/2007 Form Interrogatories - Limited Civil Cases (Economic Litigation) 10353 Civil DISC-010* 1/1/2007 Case Questionnaire-For Limited Civil Cases (Under $25,000) 10354 Civil DISC-015* 1/1/2007 Req for Stmt of Witnesses & Evidence-For Limited Cases (Under $25,000) 10355 Civil DISC-020 1/1/2007 Request for Admission 10326 Civil Exemplary Damages Attachment 982.1(13) 10330 Civil Form Interrogatories (FI-120) 10331 Civil Form Interrogatories - Economic Litigation (FI-129) 10340 Civil Fresno - Alternative Dispute Resolution (ADR) (FSC 8000) 10341 Civil Fresno - Deposit/Payment to Fresno Superior Court (TGN-62) 10346 Civil Judgment Debtor's Statement of Assets (SC-133) 10344 Civil Memorandum of Costs (MC-010) 10336 Civil Notice of Entry of Dismissal and Proof of Service (982(a)(5.1)) 10339 Civil Notice of Settlement (CM-200, 1/2007) 10333 Civil Order Approving Compromise of Claim (MC-351) 10343 Civil Order on Application for Waiver of Court Fees and Costs (982(a)(18)) 10334 Civil Order to Deposit Money Into Blocked Account (MC-355) 10332 Civil Petition to Approve Compromise of Claim (MC-350) 10313 Civil Plaintiffs Claim and ORDER to Go to Small Claims Court (SC-100) 10306 Civil Receipt for Deposit of Money Into Blocked Account (MC-356) 10329 Civil Request for Admissions (FI-100) 10335 Civil Request for Dismissal (CIV-110, 1/2007) 10345 Civil Request to Pay Judgment Installments (SC-106) 10348 Civil Request to Pay Judgment to Court (SC-145) 10315 Civil Statement of Damages - PI or Wrongful Death (CIV-050, 1/2007) 10307 Civil Subpoena 10359 Civil Subpoena (Duces Tecum) (SUBP-002, 1/2007) 10337 Civil Substitution of Attorney Without Court Order (MC-050) 10317 Civil Summons (Rev 1/2004) 10031 Claim Form WC1S 10032 Commutation Petition WC49 10403 Compex Photocopy Service - Order Form 10301 Complaint 10206 Complaint About a WCAB Judge 10522 Complaint of Discrimination under FEHA - Form DFEH-300-03 (01/05) 10416 CopyStar 10601 Corel / Word Perfect Master Merge Information 10602 Corel / Word Perfect Master Merge Letter 10513 Coverage Research Service Request (Form 807) 10037 Data Entry Sheet WC104 10080 Declaration of Custodian of Records 10038 Declaration of Readiness WC9 10417 DefensePro Order Form 10104 Deposition Attorney Fee 10302 Deposition Subpoena 10308 Deposition Subpoena - Business Records 10309 Deposition Subpoena - Personal Appearance 10223 DEU 110 - Notice of Options Following PD Rating 10164 DEU-100 Employee's PD Questionairre 10165 DEU-101 Request for Summary Rating - AME or QME 10166 DEU-102 Req for Summary Rating - PTP 10167 DEU-103 Request for Reconsideration 10168 DEU-105 Apportionment of PD 10169 DEU-200 Employee Request for Informal PD Rating 10170 DEU-201 Request for Informal Rating 10102 Discovery Order WC30A 10103 Discovery Request to Produce 10039 Dismissing Party Defendant 10040 Due Diligence Declaration 10205 DWC 280 Petition for change of PTP 10413 Expedite Copy Service 10041 Expedited Hearing WC4 10042 Expedited Hearing Spanish WC4S 10096 Expedited Hearings (A1-Law Form 10096) 10043 Failure To Prosecute Notice 10808 Family Law - Appearance, Stipulations & Waivers (FL-130) 10802 Family Law - Declaration / Uniform Child Custody (FL-105) 10805 Family Law - Notice & Ack of Receipt (FL-117) 10801 Family Law - Petition Marriage (FL-100) 10804 Family Law - Proof of Service - Summons (FL-115) 10807 Family Law - Response - Domestic Partnership (FL-123) 10806 Family Law - Response Marriage (FL-120) 10803 Family Law - Summons (FL-110) 10668 Fax Cover Sheet 10044 Fee Disclosure WC3 10045 Fee Disclosure Spanish WC3S 10046 Fee Disclosure Withdrawal WC2Withdraw 10047 Fee Pre-Application Petition WC31 10087 File Request for Walk-Through 10088 File Request Form - SM 10086 File Request Slip 10410 Gemini Duplication 10607 General Letter to Anyone (Corel) 10606 General Letter to Applicant (Spanish / Corel) 10605 General Letter To Client (English / Corel) 10048 Guardian Ad Litem WC8 10049 HCO Enrollment WC-HCO1 10526 IMC111 Medical Eval Findings Summary Form 10050 Information Guidelines For Settlement 10083 Information Request Form 10084 Information Response Form 10051 Joining Party Defendant 10052 Judge Reassignment 10019 Legal Photocopy Service - Order Form 10500 LETTERHEAD 10053 Lien WC6 (Green Paper) 10213 Lien Affidavit 10217 Lien Information Form 10054 Liens Affidavit of Good Faith WC003 10208 Longshore LS-18 Pre-Hearing Statement 10209 Longshore LS-203 Employees Claim For Compensation 10662 LTC Closing Letter, C & R Rehab Open 10661 LTC Closing Letter, C&R Rehab Closed 10608 LTC Closing Letter, C&R Rehab Closed (Corel) 10609 LTC Closing Letter, C&R Rehab Open (Corel) 10663 LTC Closing Letter, Findings and Award 10610 LTC Closing Letter, Findings and Award (Corel) 10665 LTC Failed Medical Exam 10612 LTC Failed Medical Exam (Corel) 10660 LTC General Letter to Anyone 10659 LTC General Letter to Client 10664 LTC No Representation in Liab or S & W 10611 LTC No Representation in Liab or S & W (Corel) 10418 Macro-Pro 10055 Mailing Affidavit 10012 Med-Legal Commutation Service Order Form 10011 Med-Legal HIPAA Form 10007 Med-Legal Records Authorization 10008 Med-Legal Records Declaration of Custodian 10009 Med-Legal Records Itemized Costs 10006 Med-Legal Records Order Form 10010 Med-Legal Subpoena Witness To Trial 10415 Medi-Records Reproductions 10003 MERGE CODES FOR ALL FAMILY LAW FORMS 10002 MERGE CODES FOR ALL PI FORMS 10000 MERGE CODES FOR ALL WC FORMS 10001 MERGE CODES FOR ALL WC FORMS 10412 Micro Quick Records Request Form 10625 Microsoft Word / Sample Pleading 10626 Microsoft Word Master Merge Information 10056 Minutes of Hearing 10527 Minutes of Hearing Oakland 10303 Notice and Acknowledgment of Receipt 10521 Notice and Acknowledgment of Receipt - Form 982(a)(4) 10669 Notice of Change of Address (all) 10091 Notice of Dismissal of Attorney 10085 Notice of Hearing 10532 Notice of Intention To (Form 29) 10304 Notice to Consumer or Employee 10514 Notice to Impose Sanctions - Failure to Comply with Board Rules 10510 Notice to Plaintiffs - Form VN010 10220 Objection to Treating Physicians Recommendation for Spinal Surgery (Form 233) 10057 Official Address Record Change WC001 10501 Order - General Order 10219 Order Allowing Attorney's Fees (Rehabilitation Proceedings) 10090 Order Approving C & R 10533 Order Approving C & R 10515 Order Approving C & R (DIA-65B) - Thomas v. Sport Chalet, Inc., 42 CCC 625 10516 Order Approving C & R (DIA-65E) - Rodgers v. WCAB. 50 CCC 299 10502 Order Approving C & R (Form 65, 8/85) 10504 Order Approving C & R Johnson & Sumner 10252 Order for Publication of Summons - Los Angeles 10214 Order of Dismissal 10105 Order to Produce Records 10529 Outline of Original Hearing 10751 Pension Lacera Application for Disability Retirement (DIS 101) 10753 Pension Lacera Beneficiary Designation (RSD 504) 10752 Pension Lacera Supplemental Medical Release (DIS 126) 10218 Petition for Order Allowing Attorney's Fees 10210 Petition for Penalties WC-100 10101 PETITION FOR PRE-APPLICATION DISCOVERY ORDER 10089 Petition to Reopen 10099 Petition to Reopen 10215 Petition to Terminate Liability for TD Indemnity 10202 Physician's PR2 10203 Physician's PR3 10222 Physician's PR4 - PTP P & S Report 10204 Physician's Status Report IMC81556 10201 Physicians First Report of Injury PR1 10407 Platinum Reproduction Services - Order Form 10260 Pleading - Basic 10613 Pleading - General Petition (Corel) 10059 Pre-Trial Conference Addendum 10058 Pre-Trial Conference Statement 10060 Produce Witness for Trial AT10532 10018 Professional Services - HIPAA 10017 Professional Services - The Attorneys' Aid Order Form 10081 Proof of Service 10061 Proof of Service by Mail 10062 Proof of Service of S & W 10503 Proof of Service with Verification (Rev 7/84) 10064 Publication Order 302 10063 Publication Petition PUB301 10530 QME Complaint Form 10065 QME Panel Selection QME12203 10066 Rating Employee Questionnaire DEU 100 10070 Rating Request for Consultative WC11 10071 Rating Request for Informal by Employer WC200 10072 Rating Request for Informal by Insurance WC201 10069 Rating Request for Recon To Admin DEU103 10067 Rating Request for Summary DEU 101 10068 Rating Request for Summary PTP DEU 102 10163 RB 105 Summary of Voc Rehab Benefits Provided 10411 RedStar Legal Services 10014 Republic Order Form 10095 Request for Consultative Rating 10211 Request for Consultative Rating - San Bernardino WC-1284 10534 Request for Consultative Rating, Los Angeles (WCAB-DEB-LA) 10092 Request for Dismissal 10093 Request for Dismissal - S&W 10212 Request for Dismissal of Application for Award / Violation of 132A 10519 Request for Dispute Resolution Before Admin Director (DWC-AD 10133.55) 10506 Request for Public Records 10528 Request for QME, Form 105-4062.1 Rev 2005 10221 Request for Qualified Medical Evaluator, DWC Form 106 10224 Request for Qualified Medical Evaluator, DWC Form 106 Represented Case 10097 Request For Walk-Through 10098 Request For Walk-Through DOR Only 10538 Request for Walk-Through DOR only (#2) 10419 RSP Photocopy Service 10151 RU 101 Case Initiation 10152 RU 102 Plan 10153 RU 103 Dispute Resolution 10154 RU 105 Notice of Termination 10157 RU 107A Declination of VR 10161 RU 120 Initial Evaluation Summary 10162 RU 121 Vocational Rehabilitation Progress Report 10159 RU 122 Settlement of Prospective Voc Rehab Services 10160 RU 90 Treating Physician's Report of Disability Status 10155 RU 91 Job Duties 10156 RU 94 Offer of Modified or Alternative 10016 ScanDoc Image Order Form 10108 SDT AHM 10305 SDT at Trial or Hearing 10106 SDT Attachment A Blank 10107 SDT Attachment A Wording 10128 SDT Blank 10133 SDT Fresno 10109 SDT LAO 10110 SDT LBO 10111 SDT MON 10112 SDT POM 10117 SDT Proof of Service SDT POS 10113 SDT RIV 10114 SDT SBR 10132 SDT SD 10414 SDT Services 10115 SDT VEN 10116 SDT VNO 10073 Special Notice of Lawsuit WC3SP 10311 SR1 DMV CALIFORNIA TRAFFIC ACCIDENT REPORT 10312 SR19C DMV 10476 SSA Application for SSI (Form SSA-8000-BK) 10455 SSA Appointment Of Representative (SSA-1696-U4) 10451 SSA Authorization to Disclose Information to the SSA (SSA-827) 10467 SSA Claimant's Medications (Form HA-4632) 10468 SSA Claimant's Recent Medical Treatment (Form HA-4631) 10469 SSA Claimant's Work Background (Form HA-4633) 10470 SSA Consent for Release of Information (Form SSA-3288) 10463 SSA Direct Deposit (Form 1199A) 10454 SSA Disability Report Appeal (SSA-3441-BK) 10461 SSA Disability Report SSA-3368-BK 10473 SSA Form SSA-821-BK (3-2001) ef (12-2004) Formerly SSA-821-F4 & SSA-3945-BK 10456 SSA General Authorization For Release Of Records 10472 SSA Identifying Information for Possible Direct Payment of Authorized Fees (Form SSA-1695) 10477 SSA Interview Form 10462 SSA Medical and Vocational Statement 10464 SSA Petition to Obtain Approval of Fee (Form 1560-U4) 10460 SSA Receipt for Claim for Benefits (SSA-16-F6) 10452 SSA Request For Hearing By Administrative Law Judge (HA-501-U5) 10453 SSA Request For Reconsideration (SSA-561-U2) 10465 SSA Request for Reconsideration - Disability Cessation (Form 789-U4) 10458 SSA Request for Review of Hearing Decision/Order (HA-520-U5) 10459 SSA Request for Social Security Information (SSA-7050-F4) 10466 SSA Request for Waiver of Overpayment Recovery (Form 632-BK) 10475 SSA Statement of Claimant Or Other Person (Form SSA-795) 10457 SSA Two-Tier Fee Agreement, Social Security/SSI 10474 SSA Work History Report (Form SSA-3369-BK) 10471 SSA Workers' Compensation/Public Disability Benefit Questionnaire (Form SSA-546) 10250 Status Conference Questionnaire - Los Angeles 10505 Stipulation and Award and/or Order (Form 5, 10/2005) 10216 Stipulation and Order to Pay A Lien Claimant 10075 Stipulation for Award Death WC4A 10074 Stipulations for Award WC3 10518 Stipulations for Award WC3 (Pre 2005) 10118 Subpoena AHM 10119 Subpoena ANA 10134 Subpoena Fresno 10120 Subpoena LAO 10121 Subpoena LBO 10122 Subpoena MON 10123 Subpoena POM 10130 Subpoena RDG 10124 Subpoena RIV 10125 Subpoena SBR 10131 Subpoena SD 10126 Subpoena VEN 10127 Subpoena VNO 10076 Substitution of Attorney WC36 10082 Summary of Settlement Conf Proceedings 10310 Summons Proof of Service 10013 Superior Imaging 10409 US IMAGING 10531 Utilization Review complaint form 1 (Form DWC UR) 10508 Ventura - Consent for Court Assignment - Family Law - Form VN027 10507 Ventura - Declaration for Court Assignment - Family Law - Form VN027 10077 Venue Authorization WC105 10078 Verification 10524 Verification / POS 10158 Voc Rehab Reply Form - DWC 500-L 10537 WC Commutation Request Form 10512 WC Cover Sheet (Legal Size / Style #2) 10511 WC Cover Sheet (Letter Size / Style #1) 10525 WC Cover Sheet (Legal Size / Style #3) 10536 WC Cover Sheet 2 10535 WC Monthly Status Call 10129 WC32 10094 WCIRB Request Form 10627 Word Sample Letter 10405 XACT Copy
