FINAL ADMISSION OF LIABILITY - Colorado
List names and addresses of all persons copied: Name Address Claimant: Claimant’s Attorney: Employer: Carrier’s Attorney: Division of Workers’ Compensation, 633 17th St., Suite 400, Denver, CO 80202-3626 By WC4 Rev 07/14 Page 1 of 4 See page 2 for important notices and codes Block # Adj. Code ................
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