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8 JUDGMENT
.r WORKERS' COMPENSATION a DISMISSAL
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a DISCONTINUANCE
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i/ ORDER FORJUOGMENT: It eDoeanng that tn Petitioner suffered a comoenssble injury on the above mentioned data while m the amploy of respondent: it
ii Ordtrad and Adiuoged dies petitioner ba awarded compensation benefits. Payable as indicated on Page 2-
ORDER APPROVING SETTLEMENT: The partial having tattled tha matter and a finding by the Court having bean made that tha terms of the settlement are fair and
just, it is Ordered tnat this settlement be eoproved and the petitioner be paid as indicated on Page 2.
ORDER FOR DISMISSAL This matter having come on for hearing upon the rewondent's motion for Dismissal which was made and dtilv served and there
being good causa shewn, the claim petition herein is hereby dismissed for
__ 1 Lack of Prosecution
2.
~ ORDER FOR DISCONTINUANCE This matter having come on before the court and the court having received evidence that this matter should be discontinued and
for good cause shown. It is OROEREO AND ADJUDGED that this matter be discontinued lor the following reasons:
It is FURTHER OROERED thet the payment indicated on Page 2 be made a part of the Order for Discontinuance for petitioner's disability. (Percentages and members involved.!
we Htneev consent to the entry ano fORM OP THIS OROER ANO ACKNOSVLEDSC receipt OP A COPY iSitn .1 aooiicebiel
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ipETitioner S aTTORnEvi PETITIONER Irvnw AeRAceoier IRESPOLOENT S ATTORNEY) '
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mtAWlNtrOf riCiAuSiGNATuREI
(NAME OF HEARING < Judge of Comoensstion
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GAF 15039
Mate o*
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Oeoanment of Lieor
& JUOGMENT 13 APPROVING SETTLEMENT
DIVISION OP WORKERS' COMPENSATION C3 DISMISSAL
________ ____________________ DISCONTINUANCE P*pp*-.*R*nt 0-*D''.t> Oubibt Percentages. **crurr and ax ten: of OiiAbtIir\ and Membert Imohedi
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TOTAL
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petitioner
respondent
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STENOGRAPHIC SERVICE
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PETITIONER
RESPONDENT
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wC hCPCEV CONSENT TO TMC I roM op this OPOfP ANO aCkNOWlEOOE A COPY:
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Sri^SofpiCiau v^a*3 . ^5&9h^ W G*ft&ojJIh.i (OATc)
!^a> Jud* of Comppnution
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1P6T1T16NER S ATTORNEYI
[RESPONDENT'S ATTORN^l /
PETITIONER -White Applicable} v*C ;93-l
= S?0NDENTS attorney
GAF 15040