Louisiana Administrative Code
Title 40 - LABOR AND EMPLOYMENT
Part I - Workers' Compensation Administration
Subpart 3 - Hearing Rules
Chapter 66 - Miscellaneous
Subchapter E - Forms
Section I-6645 - Subpoena and Subpoena Deuces Tecum ; Form LDOL-WC-1006C

SUBPOENA AND SUBPOENA DUCES TECUM

* DOCKET NO. DISTRICT

VERSUS * OFFICE OF WORKERS' COMPENSATION

* STATE OF LOUISIANA

TO ___________________________________________

______________________________________________

YOU ARE HEREBY COMMANDED to appear before the Workers' Compensation Court at

_______________________________________________________________________________________________________________________ ,

_______Telephone # ___________at____________ o'clock

________ .m. on the____________ day of, 20|___________, or on any other day that this matter may be continued to give testimony in the above entitled and numbered cause. You must remain in Court until discharged by the Judge. You must testify to the truth, to the best of your knowledge in this case.

YOU ARE/ARE NOT (circle one) FURTHER COMMANDED to produce at the above time and place the following:

FAILURE TO APPEAR OR PRODUCE AS DIRECTED ABOVE SHALL SUBJECT YOU TO ANY PENALTY AS PRESCRIBED BY LAW.

This SUBPOENA was issued by the Office of Workers' Compensation on the ______________ day of __________________________________, 20________.

______________________________________

J. KAREN BEVAN, RECORDS MANAGER

Office of Workers' Compensation

_________________________ ________________________

_________________________

Telephone: ( )___________________

AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1310.1.