§ Form No. 10 Response to petition for review

Form No. 10. Response to petition for review

    IN THE SUPREME COURT OF THE STATE OF OKLAHOMA

    ___________________________________                      )

    ___________________________________,                      )

    )

    Petitioner,                                                                    )

    v.                                                                                 )                   No. _______________

 )

    ___________________________________                       )

    ____________________, and                                          )

    THE WORKERS' COMPENSATION                                 )

    COURT,                                                                          )

    )

    Respondents.                                                                 )

    RESPONSE TO PETITION FOR REVIEW

    A. If other than entire transcript is designated by petitioner, estimate number of additional pages needed: _______

    B. Respondent's brief statement as to proceeding:

    Exhibit “A” attached (not to exceed one 8 1/2 ” x 11” double spaced page).

    DATE: _______________, 19___.

    Verified by: ___________________________________________

    (Signature of Attorney or Pro Se Party)

    OBA No.: ___________________________________________

    Firm: ___________________________________________

    Address: ___________________________________________

    ___________________________________________

    ___________________________________________

    Telephone: ___________________________________________

    CERTIFICATE OF FILING AND MAILING

    I _______, do hereby certify that on this ____ day of _______, 19___, I did cause to be filed with the Workers'      Compensation Court, a correct copy of the Response to the Petition for Review in Error, and also mailed a copy by first class mail, postage prepaid to:

    [Names and addresses of all parties or counsel of record]

    ________________________________________________________________________________

    Adopted July 10, 1996

    Effective January 1, 1997

    Heading renumbered by order of May 5, 2005, which added a new Part IX.
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