This form may be produced without a logo and may be produced on the claim's administrator's letterhead.
Cal. Code Regs. Tit. 8, § 10133.32
2. New section refiled 6-26-2013 as an emergency; operative 7-1-2013 pursuant to Government Code section 11346.1(d) (Register 2013, No. 26). A Certificate of Compliance must be transmitted to OAL by 9-30-2013 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 7-1-2013 order, including amendment of form, transmitted to OAL 9-27-2013 and filed 11-8-2013; amendments operative 1-1-2014 (Register 2013, No. 45).
4. Change without regulatory effect amending section filed 2-5-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 6).
5. Change without regulatory effect repealing and adopting new section filed 11-23-2015 pursuant to section 100, title 1, California Code of Regulations (Register 2015, No. 48).
Note: Authority cited: Sections 133, 4658.1, 4658.7 and 5307.3, Labor Code. Reference: Sections 4658.6 and 4658.7, Labor Code.
2. New section refiled 6-26-2013 as an emergency; operative 7-1-2013 pursuant to Government Code section 11346.1(d) (Register 2013, No. 26). A Certificate of Compliance must be transmitted to OAL by 9-30-2013 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 7-1-2013 order, including amendment of form, transmitted to OAL 9-27-2013 and filed 11-8-2013; amendments operative 1-1-2014 (Register 2013, No. 45).
4. Change without regulatory effect amending section filed 2-5-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 6).
5. Change without regulatory effect repealing and adopting new section filed 11-23-2015 pursuant to section 100, title 1, California Code of Regulations (Register 2015, No. 48).