New Mexico Administrative Code
Title 11 - LABOR AND WORKERS' COMPENSATION
Chapter 5 - OCCUPATIONAL HEALTH AND SAFETY
Part 5 - OCCUPATIONAL HEALTH AND SAFETY REVIEW COMMISSION PROCEDURES
Section 11.5.5.1014 - SAMPLE NOTICE OF WITHDRAWAL OF CONTEST OR PETITION

Universal Citation: 11 NM Admin Code 11.5.5.1014

Current through Register Vol. 35, No. 6, March 26, 2024

A. Format:

STATE OF NEW MEXICO

BEFORE THE OCCUPATIONAL HEALTH AND SAFETY REVIEW COMMISSION

[NAME OF COMPLAINANT OR PETITIONER],

[complainant/Petitioner],

v. No. [insert case no.]

[NAME(S) OF RESPONDENT(S)],

respondent[s].

NOTICE OF WITHDRAWAL OF [CONTEST/PETITION]

[respondent/Petitioner], [Name of respondent or Petitioner, as applicable], hereby gives notice of the unconditional withdrawal of the [Notice of Contest/Petition for Modification of Abatement Period] in this matter.

[Signature] _______________________________

[TYPED OR PRINTED NAME]

[Address of signer (use as many lines as necessary)]

[Signer's telephone number]

B. Usage note: Include Certificate of Service (Section 1001) [now 11.5.5.1001 NMAC], on or immediately following the signature page.

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