SAMPLE REPORT - FOR DISPLAY PURPOSES ONLY

EDEX Express Hearing Notice
LE1234 - FLOYD, CHRISTOPHER M.
Page: 1 of 1		 California Administration, Inc.
Post Office Box 31
Martell, CA 95654
(800) 832-7333
Account: California Administation, Inc.
                 P. O. Box 31
                 Martell, CA 95654		 File Number:            LE1234-654987-123456
Transaction Date:   02/11/98
Reception Date:      02/15/98

NOTICE OF HEARING
Injured Worker Name:
SSN :
WCAB Case Number:

Transaction Type:
Hearing Type:
Hearing Date:
Hearing Time:
Scheduled Length:
WCAB Judge:

Location:
Address / Phone:

Comments:

 FLOYD, CHRISTOPHER M.
123-45-6789
VNY 1234567

New Setting
Regular Trial
Monday June 1, 1998
8:30am
Full Day
(999) Smith, Robert

Van Nuys WCAB Office
12345 Van Nuys Blvd., Van Nuys, CA 90001   (310) 555-1212

All parties must appear at this hearing (including all lien claimants). 

OFFICIAL ADDRESS RECORD
Injured Worker Injured Worker Attorney Employer
   Floyd, Christopher M.
   P. O. Box 31
   Martell, CA 95654
   (800) 832-7333		    Gangemi, Donald
   4321 Anystreet
   Chico, CA 95321
   (916) 555-1212		    California Administration
   P. O. Box 31
   Martell, CA 95654
   (800) 832-7333
Defense Attorney Insurer Lien Claimant
   Dewey, Cheatem and Howe
   1000 Sunshine Street
   Los Angeles, CA 00001
   (213) 555-1212		    Best of the West Insurance
   P. O. Box 12345
   Bakersfield, CA 00015
   (805) 555-1212		    Dr. James Kevin, M.D.
   12345 Surgery Circle
   Sacramento, CA 95001
   (916) 555-1234
Lien Claimant Lien Claimant Lien Claimant
   EDD - Sacramento
   P. O. 958
   Sacramento, CA 91001
   (916) 555-4321		    Doc-U-Copy Copy Service
   87654 Paper St.
   Los Angeles, CA 12345
   (213) 555-6543		    MRI Imaging Center
   12500 Magnet Drive
   Los Angeles, CA 95400
   (213) 555-9821