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Get Certification Sbwc Print 2011-2024

Of the Georgia Rules of Professional Conduct, Board Rule 108 and Board Rule 15 and that I am charging a fair and reasonable fee to my client whi ch does not exceed 25% as allowed by O.C.G.A. 34-9-108 and Board Rule 108 as they apply to the alleged accident date(s) of : This day of (Day) . / (Month) (Year) Print Name Address Signature Telephone Number City GA Bar Number State Zip Code IF YOU HAVE QUESTIONS PLEASE CONTACT THE STATE BOARD OF W ORKERS COMPENSATION AT 404-656-3818 O.

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