Report Of Litigation Expenses (Claimants' Attorney) printable pdf download

Report Of Litigation Expenses (Claimants' Attorney)

INDUSTRIAL COMMISSION

P. O. BOX 83720

BOISE, ID

83720-0041

I.C. CASE NO. ________________

I.C. CASE NAME _____________________________________________

_____________________________________________________

REPORT OF LITIGATION EXPENSES

(CLAIMANTS' ATTORNEY)

In accordance with the requirements of Section 72-528, Idaho

Code, this form shall be filled out and returned to the

Industrial Commission within 30 days following the time of entry

of a final award by the Industrial Commission in the above case,

or, in the event of an appeal to a final court, within 30 days

following a final ruling by the court.

If there is an appeal,

the totals specified below shall include the expenses, costs, or

fees incurred in the appeal.

Attorneys fees incurred in litigation and charged

to claimant:

$_____________________

2. Expenses incurred in litigation and charged

to claimant:

$_____________________

TOTAL

$_____________________

Dated this ________ day of _______________, 19____.

FIRM NAME ____________________________________________

BY____________________________________________________

IC Form 1022

IDAPA 17.02.05.281

Report Of Litigation Expenses (Claimants' Attorney)