DWC-CA Form 10214(B) Stipulations With Request for Award (Death Case) - California

DWC-CA Form 10214(B) Stipulations With Request for Award (Death Case) - California

What Is DWC-CA Form 10214(B)?

This is a legal form that was released by the California Department of Industrial Relations - Division of Workers' Compensation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DWC-CA Form 10214(B)?A: DWC-CA Form 10214(B) is a form used in California for stipulations with a request for award in death cases.

Q: What does the form involve?A: The form involves stipulations, which are agreements between the parties involved, and a request for an award in a death case.

Q: Who uses this form?A: This form is used by parties involved in a workers' compensation case in California where a death has occurred.

Q: What is the purpose of this form?A: The purpose of this form is to formalize agreements between the parties and to request an award in a death case.

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Form Details:

  • Released on November 1, 2008;
  • The latest edition provided by the California Department of Industrial Relations - Division of Workers' Compensation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of DWC-CA Form 10214(B) by clicking the link below or browse more documents and templates provided by the California Department of Industrial Relations - Division of Workers' Compensation.

Download DWC-CA Form 10214(B) Stipulations With Request for Award (Death Case) - California

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