ࡱ> { bjbjzz 7 ((((Lt(*=.X """""%s';;;;;;;$X> Av<)""))<""<333) "";3);33r79"VA)"8;<0*=8A)A9A9?(Z(@3(4 )?(?(?(<<.?(?(?(*=))))A?(?(?(?(?(?(?(?(?( : State of New Jersey Department of Labor and Workforce Development DIVISION OF WORKERS COMPENSATION WC-374i (3/19/13)ORDER FOR TOTAL DISABILITY CASE NO S.:  FORMTEXT       VICINAGE:  FORMDROPDOWN  PETITIONERSOCIAL SECURITY NUMBER:  FORMTEXT      ATTORNEY FOR PETITIONER FORMCHECKBOX  SSN  FORMCHECKBOX  FEDERAL EMPLOYER NUMBER  FORMCHECKBOX  NJ REG NUMBER  FORMTEXT      NAME:  FORMTEXT      NAME::  FORMTEXT      DATE OF BIRTH:  FORMTEXT      MEDICARE ELIGIBLE:  FORMCHECKBOX  YES  FORMCHECKBOX  NOADDRESS:  FORMTEXT       ADDRESS (Including County):  FORMTEXT       TELEPHONE NUMBER (AREA CODE):  FORMTEXT       RESPONDENTvsAPPEARING:  FORMTEXT      NAME:  FORMTEXT      ADDRESS (Including County):  FORMTEXT        INSURANCE CARRIERNAME :  FORMCHECKBOX  SELF-INSURED  FORMCHECKBOX  TPA  FORMTEXT      CLAIM NUMBER;  FORMTEXT      ATTORNEY FOR RESPONDENTNAME:  FORMTEXT      DATE OF ACCIDENT OR OCCUPATIONAL EXPOSURE:  FORMTEXT      ADDRESS:  FORMTEXT      DESCRIBE (Briefly):  FORMTEXT      TELEPHONE NUMBER (AREA CODE):  FORMTEXT       APPEARING:  FORMTEXT       Weekly Wages: $  FORMTEXT      Rate(s): $  FORMTEXT       / $  FORMTEXT       IF RE-OPENED PETITION, INDICATE FOR LAST AWARD: DATE:  FORMTEXT       PERMANENT: $  FORMTEXT       TEMP: $  FORMTEXT       This matter having come before the COURT on this  FORMTEXT       day of  FORMDROPDOWN ,  FORMDROPDOWN  :  FORMCHECKBOX ORDER FOR JUDGMENT It appearing that the Petitioner suffered a compensable injury on the above mentioned date while in the employ of respondent; It is Ordered and Adjudged that Petitioner be awarded compensation benefits, payable as set forth below.  FORMCHECKBOX ORDER APPROVING SETTLEMENT The parties having settled the matter and a finding by the Court having been made that the terms of the settlement are fair and just; It is Ordered that this settlement be approved and the petitioner be paid as set forth below. PERMANENT DISABILITY:  FORMTEXT       State of New Jersey Department of Labor and Workforce Development DIVISION OF WORKERS COMPENSATION WC-374i (8-14-09)ORDER FOR TOTAL DISABILITY Page 2 CASE NO S.:  REF Text1   VICINAGE:  REF Dropdown1   TEMPORARY:  FORMTEXT       Weeks at $ FORMTEXT       = $ FORMTEXT      less $ FORMTEXT       paid = Balance due $ FORMTEXT      PERMANENT:  FORMTEXT       Weeks at $ FORMTEXT       = $ FORMTEXT      less $ FORMTEXT       paid = Balance due $ FORMTEXT       FORMCHECKBOX  Voluntary Tender  FORMCHECKBOX  Reopener Credit MEDICAL BILLS (Doctors and/or Institutions):  FORMTEXT       An application for Social Security Disability Benefits and / or Government Ordinary Disability Pension  FORMCHECKBOX  is pending  FORMCHECKBOX  is on appeal  FORMCHECKBOX  has not been filed. Should Petitioner be awarded Social Security Disability Benefits and / or Government Ordinary Disability Pension, Petitioner shall immediately notify the Respondent of this award. The Petitioner shall reimburse the Respondent for any workers compensation benefits paid to Petitioner in excess of the statutory offset rate during the period of time Petitioner has received Social Security Disability benefits or Government Ordinary Disability Pension. In the event there is a change in the number or status of the auxiliary beneficiaries while Petitioner is receiving Workers Compensation benefits, Petitioner shall immediately notify the Respondent. I further Order that Respondent furnish the Petitioner such medical attention, prosthesis, and medical supplies as the condition of the Petitioner may require. Should any emergency arise, necessitating immediate medical attention for the Petitioner, notice and request to Respondent shall not be necessary.  FORMCHECKBOX  Respondent authorizes  FORMTEXT       as treating physician. The date of Petitioner s Permanent Total disability is  FORMTEXT       . On  FORMTEXT       which is the expiration of the 450 week period, benefits to continue in accordance with the provision of N.J.S.A." $ & 8 B D X Z \ f h | ~ ú{h\Pæhbhzj5CJaJhNG hzj5CJaJ%jhh5CJUaJmHnHu&jh/ +h/ +5CJUaJh/ +5CJaJjh/ +5CJUaJhzjCJaJh#hzj5CJaJhzj5CJaJh#hzj5CJaJh#hzjCJaJh/UCJaJh$LCJaJh#h$LCJaJh#hzjCJaJ( $ & p ~ $IfgdA $$Ifa$gdA $$Ifa$gdzj $Ifgd/U $Ifgdzj tk_k $$Ifa$gdA $IfgdAkdt$$Ifl4Fx+N 0    4 laytA    * , . 8 : < l n {k`TL:T#jHhChuCJUaJhuCJaJjhuCJUaJhmhuCJaJjhuUaJmHnHujhhuUaJhhuaJjhhuUaJhuCJ aJh#huCJ aJh#hu5CJaJhuh1CJ aJhzjCJaJj/hhUaJ h/ +aJjh/ +UaJh#hzjB*CJaJph  < l to[RE[ $Ifgdu $Ifgdu$qq$If]q^qa$gdugd*kd$$Ifl4Fx+N 0    4 laytA   . 0 2 6 R b d f z | ~ ֵꫥzocꫥSjhkIxhuUaJh#hu5CJaJh#huCJaJhcahuCJaJjhuUaJmHnHujh huUaJ huaJjhuUaJj0hhCJUaJ#jhChuCJUaJhuCJaJjhuCJUaJh#huCJ aJh#huCJaJ l d iUL; $If^gdu $Ifgdu$qq$If]q^qa$gduxkd$$Ifl4^\d&+zVr4 laf4ytu $If^gdu dt$Ifgdu  4 6 8 B D F l n ֘l]Rh!ThuCJ aJjh!ThuCJ UaJ$jh bhuUaJmHnHujh bhuUaJh bhuaJjh bhuUaJh#huCJaJjhhUaJmHnHujih huUaJ huaJhuCJ aJh#hu5CJaJh#huCJ aJjhuUaJ  `L$qq$If]q^qa$gduxkd$$Ifl4\d&+zVr4 laf4ytu $If^gdh $Ifgdu $$Ifa$gdu F l     $If^gdu $$Ifa$gdu $Ifgdu $If^gdu         P R ӮȣqaYNFhuCJ aJh#huCJaJhuCJaJjhuUaJmHnHuj hhuUaJhhuaJjhhuUaJh#hu5CJaJh#huCJ aJ#j h!ThuCJ UaJhuCJaJh(fhuCJaJh!ThuCJ aJjh!ThuCJ UaJ#j* h!ThuCJ UaJ   R z | ~ s_VEVVV $If^gdu $Ifgdu$qq$If]q^qa$gdukdp $$Ifl4r d&+z  `r4 laf4ytuR T h j l v x z (*,@򾶫y򶉟me[T huaJ*jhuUaJhuCJ aJh#hu5CJaJj hhuUaJh#huCJaJh#huCJ aJh#hu5CJaJhChuCJaJhuCJaJh}OhuCJaJjhuUaJmHnHujL hhuUaJhhuaJjhhuUaJ q]$qq$If]q^qa$gduxkd $$Ifl4\d&+z`V r4 laf4yt` $$Ifa$gdu $Ifgdu *Ruii`W $Ifgdh $Ifgdu $$Ifa$gduqq$If]q^qgduxkd $$Ifl4\d&+z Vr4 laf4ytu@BDNPRTVbdxz|<Rtdt̪[[[hu5CJaJjehhuUaJjhuUaJmHnHuj&hhuUaJhhuaJjhhuUaJh#huCJ aJh#hu5CJaJh#huCJaJhuCJaJjhhUaJmHnHujhuUaJ"j hq=huUaJ*#RTVbriXLX $$Ifa$gdu $If^gdu $Ifgdu$qq$If]q^qa$gduxkdA$$Ifl4\d&+zVr4 laf4ytuTriXiiD$qq$If]q^qa$gdu $If^gdu $Ifgdu$qq$If]q^qa$gduxkd$$Ifl4\d&+zVr4 laf4ytuT6ULL $Ifgduxkd9$$Ifl4P\d&+z`Vr4 laf4ytu $If^gdu dt$Ifgdu$qq$If]q^qa$gduNPlnpr468L٪zocWh#hu5CJaJh#hu5CJ aJh#huCJaJjhuUaJmHnHujhkIxhuUaJ huaJjhuUaJ#jOhChuCJUaJh#huCJaJ#jhChuCJUaJhuCJaJjhuCJUaJhuCJ aJh#huCJ aJLNPZ\`*,@BDNPRTVhʾ孝峾xo_xOxʾjhuUaJmHnHuj;hhuUaJhhuaJjhhuUaJhuCJ aJjhhUaJmHnHujh huUaJ huaJh#huCJ aJh#hu5CJaJh#huCJaJjhuUaJmHnHujhuUaJj=hkIxhuUaJ6^`RuaXGaXX $If^gdh $Ifgdu$qq$If]q^qa$gduxkd$$Ifl4\d&+z Vr4 laf4ytu $If^gduRTVhriXriX $If^gdu $Ifgdu$qq$If]q^qa$gduxkd$$Ifl4\d&+zVr4 laf4ytuhj~"$8:<FHLNPRThjl򾲾򾏲򾲾uo_ujhq=huUaJ huaJjhuUaJjhhuUaJh#huCJaJj&hhuUaJhuCJ aJh#hu5CJaJh#huCJ aJjhuUaJmHnHujhhuUaJhhuaJjhhuUaJ%"JLNPriXiri $If^gdu $Ifgdu$qq$If]q^qa$gduxkd$$Ifl4\d&+zV`r4 laf4ytuPRTjriXri $If^gdh $Ifgdu$qq$If]q^qa$gduxkd$$Ifl4m\d&+zV r4 laf4ytu$&08:NĹrjbbRrjh/Uh[p5Uh/Uh"NC5h/Uh25#jh/UhT5UmHnHuj;h/Uh[p5Ujh/UhB 5Uh/UhB 5h/Uht5h/Uhn5huhuCJ aJh#huCJaJh#hu5CJaJh#huCJ aJjhuUaJjhhUaJmHnHu `xx $Ifgd2gd*xkdX$$Ifl4j\d&+zV r4 laf4ytuNPR\^bd26:<PRTžwok^N^jh/UhS>*Ujh/UhS>*Uh`RAh/Uh`RA>*#jh/UhT>*UmHnHujGh/Uh!u>*Uh/Uh!u>*jh/Uh!u>*Uh/UhS>*h/UhS5 h;hShnh/Uhn5#jh/UhT5UmHnHujh/UhB 5Uj+h/Uh[p5U`bdvqdWNE $Ifgdh $IfgdS 5$Ifgd/U $Ifgd/Ugdnkd$$Ifl{0+$ t0644 lapyt/UT^`ft~(.02<>@PRdfڛẁ|okhSjQ hh>*U hL:>*jhL:>*Ujh/Uhh>*Uh`RA!jh/UhS>*U*h/UhS>**h/Uh`RA>*j3h/UhS>*Uh/UhS5 h;hSh/UhS>*jh/UhS>*Ujhh>*U) vw $IfgdM $$Ifa$gdMgdnIkd $$Ifl+(, t644 lap yt/U'xy  տլwe]h/Uh)-5#jh/UhT5UmHnHuj"h/Uhf5Uh/Uhf5jh/Uhf5Uh/Uhba5h/UhB 5hn{?h 5j"hTU hn{?hA hn{?h hn{?hn5 hn{?hnjD!hTU hn{?h_M*jhn{?h_M*U hn{?hHO wx2BSkd{"$$Ifl0v+") t644 la $IfgdM $$Ifa$gdMSkd!$$Ifl0v+") t644 la:zzzzzn $$Ifa$gdzj $Ifgdzjgd okdB#$$Ifs +(, t0(,44 sap yt/U$If 4DFX`bdz|Ź똊rcXKjh/ +B*UphhbhzjB*phh#hzjB*CJaJphhh5CJaJmHnHuh/ +5CJaJjh/ +5CJUaJhhzj5CJaJh#hzj5CJaJhzj5CJaJh#hzj5CJaJh#hzjCJaJhI3CJaJh#hI3CJaJhzjCJaJh#hzjCJaJh 5CJaJ6DF Skd#$$Ifl4Fj+j0    4 laytA $IfgdA $$Ifa$gdA $$Ifa$gdzj   &(<>@JLNPfh|~ʾ}rr`}rrN#j0&h/Uh$LCJUaJ#j%h/Uh$LCJUaJh/UhzjCJaJ(jh/UhTCJUaJmHnHu#jD%h/Uh$LCJUaJh/Uh$LCJaJjh/Uh$LCJUaJh/Uhzj5CJaJh 5CJaJh#hzjCJaJhzjCJaJhhjh/ +B*Uphh/ +B*ph  &PftobYPPC $If]gd/U $IfgdJ $IfgdT $If]gd/Ugd kd$$$Ifl4Fj+j0    4 laytA "$8:<FHN`bz|ܺŝܺܺmbbܺh/UhVdCJaJ#jR0h/Uh$LCJUaJh/UhVd5CJaJ#j'h/Uh$LCJUaJh/UhP(@CJaJ#j&h/Uh$LCJUaJh/Uh$LCJaJh/UhzjCJaJh/Uhzj5CJaJjh/Uh$LCJUaJ(jh/UhTCJUaJmHnHu$"JLNPRTVXZ\^`bzFf-$$If^a$gd/U $If]gd/U $IfgdA $If]gd/UFfB) $If]gd/U$If]^gd/U $IfgdJz"LvD $If^gd/U $IfgdA $If]gd/UFf4 $If]gd/U$If]^gd/U $If]gd/U $IfgdJ"$8:<FHJLptvx޾ާ޲ާ޾xާf޲Zh/Uhzj5CJaJ#j1h/Uh$LCJUaJh/UhP(@CJaJ#j1h/Uh$LCJUaJ#j&1h/Uh$LCJUaJh/Uh$LCJaJh/UhVd5CJaJh/UhVdCJaJ(jh/UhTCJUaJmHnHujh/Uh$LCJUaJ#j0h/Uh$LCJUaJ" "DFH saYQFh/Uh CJaJh CJaJh/Uhw{5#jh/UhT5UmHnHuj <h/Uh2S5Uh/Uh2S5jh/Uh2S5Uh/Uhw{5aJhzj5CJaJh/Uhzj5CJaJ#j7h/UhTCJUaJh/UhXCJaJ#j-7h/UhTCJUaJjh/UhzjCJUaJh/UhzjCJaJDFH ""x#}maaX $Ifgd $$Ifa$gd/U$$If`a$gd/Uokdv<$$Ifs(+(, t0(,44 lap yt/U $Ifgdw{gd Ff9 \%^%`%|%~%%%%%%%%{j^Jj&j>h/UhA>*CJUaJh/Uhzj>*CJaJ jh/Uhzj>*CJUaJh/Uh >*CJaJ#je>h/UhTCJUaJh/UhOCJaJ#j=h/UhTCJUaJh/Uh0CJaJ#j{=h/UhTCJUaJ#j=h/UhTCJUaJh/Uh CJaJjh/Uh CJUaJx#y#\%^%.&0&&&46 gd gd Ikd=@$$IflM+(, t644 lap yt/U $Ifgd $$Ifa$gd/U%%%%&&&&&&&&&&&&''''''(ص̐pncXMh#hACJaJh#hh,CJaJh/Uh CJaJU&j?h/Uh[>*CJUaJh/Uh[>*CJaJ jh/Uh[>*CJUaJ&jQ?h/UhA>*CJUaJh/Uhzj>*CJaJh/Uh CJaJh/Uh >*CJaJ jh/Uhzj>*CJUaJ+jh/UhT>*CJUaJmHnHu 34:15-12(b) as amended. Pursuant to N.J.S.A. 34:15-12(b), petitioner will be referred to the Division of Vocational Rehabilitation Services for evaluation and services prior to the expiration of 450 weeks from the date of Total Permanent Disability.  State of New Jersey Department of Labor and Workforce Development DIVISION OF WORKERS COMPENSATION WC-374i (8-14-09)ORDER FOR TOTAL DISABILITY Page 3 CASE NO S.:  REF Text1   VICINAGE:  REF Dropdown1   REIMBURSETAX IDENTIFICATION NUMBERTOTAL AMT. ALLOWEDPAYABLE BY PETITIONERPAYABLE BY RESPONDENTMEDICAL FEE ALLOWED: (expert and/or testimonial)  FORMTEXT        FORMDROPDOWN   FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMDROPDOWN   FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMDROPDOWN   FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMDROPDOWN   FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN   FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      ATTORNEY(S) FEE:  FORMTEXT        FORMDROPDOWN   FORMTEXT        REF Text101 \* MERGEFORMAT   FORMTEXT       FORMTEXT       FORMTEXT      STENOGRAPHIC SERVICE:  FORMDROPDOWN   FORMDROPDOWN   FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      MISCELLANEOUS FEES: (fill in below)  FORMTEXT        FORMDROPDOWN   FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMDROPDOWN   FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMDROPDOWN   FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMDROPDOWN   FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMCHECKBOX  ORDER FOR CHILD SUPPORT  FORMCHECKBOX  ADDENDUM ATTACHED MEDICARE ELIGIBILITY: PETITIONER ( FORMCHECKBOX  IS) ( FORMCHECKBOX  IS NOT) ELIGIBLE FOR MEDICARE  FORMTEXT       JUDGE OF COMPENSATION DATE WE HEREBY CONSENT TO THE ENTRY AND FORM OF THIS ORDER AND ACKNOWLEDGE RECEIPT OF COPY:  REF Text19 \* MERGEFORMAT  ,  REF Text16 \* MERGEFORMAT   Petitioner s Attorney REF Text15 \* MERGEFORMAT  ,  REF Text12 \* MERGEFORMAT   Respondent s Attorney Petitioner (where applicable)   ,8:<>PXZ\rt~ǻ푃zk\Qhbh/ +B*phh#h/ +B*CJaJphhh5CJaJmHnHuh/ +5CJaJjh/ +5CJUaJhh/ +5CJaJh#h/ +5CJaJhl5CJaJh/ +5CJaJh#h/ +5CJaJh#h/ +CJaJhI3CJaJh#hI3CJaJh/ +CJaJh#h/ +CJaJh CJaJ 2ҊԊ .<> $$Ifa$gd/ + $Ifgd/ + tk_k $$Ifa$gd/ + $Ifgd/ +kd@$$Ifl4Fj+j0    4 layt/ +ȋʋ ЌҌ246JLNXZ`bȺtbtPtFjhUaJ"jhTCJUaJmHnHu#jBh}OhCJUaJjh}OhCJUaJh}OhCJaJh}Oh6CJaJh}Oh5CJaJh5CJaJh}OhCJaJh}Oh56CJaJh#h5CJaJh#h/ +CJaJh/ +CJaJhhh/ +B*phjh/ +B*Uph RxЌtofZZZZZZ $$Ifa$gd= $Ifgd=gd kdKA$$Ifl4Fj+j0    4 layt/ + ЌҌ\^`7... $Ifgd=kdB$$IflֈjV^X %+ t0,44 laytb~čƍЍҍԍ֍ "$&:<>HJLNPdػشԩػشԞػشԓػشԈػش}n}jh}OhCJUaJh}OhCJaJjEhUjMEhUjDhUjaDhU hhjhTUmHnHujCh)UhjhUjhUaJj+ChThTUaJ haJ*`ԍ$L $$Ifa$gdw $$Ifa$gd) $$Ifa$gdLNvxz5,,, $Ifgd=kd9F$$Ifl0ֈjV^X %+ t0,44 layt)dfhrtz|ŽĎƎȎ܎ގ,|uj|u_|ujIhUjHhU hhjhTUmHnHuj4HhUhjhUjhGhThTUaJ haJjhUaJh}OhCJaJ"jhTCJUaJmHnHujh}OhCJUaJ#jFh}OhCJUaJ!zƎ>f $$Ifa$gdw $$Ifa$gd) $$Ifa$gd,.0:<>@TVXbdfhj~ΏЏҏ܏ޏ׽zjz_jqLhUjKhThTUaJ haJjhUaJ"jhTCJUaJmHnHu#j/Kh}OhCJUaJjh}OhCJUaJh}OhCJaJjJhUh hhjhTUmHnHujhUjIhU"fh5,,, $Ifgd=kdvJ$$IflֈjV^X %+ t0,44 layt)0X $$Ifa$gdw $$Ifa$gd) $$Ifa$gd  ",.02FHJTVXZnpr|~̐ӽӲקtjd haJjhUaJ"jhTCJUaJmHnHu#jlOh}OhCJUaJjh}OhCJUaJh}OhCJaJj=NhUjMhUjQMhUh hhjhTUmHnHujhUjLhU$5,,, $Ifgd=kdN$$IflֈjV^X %+ t0,44 layt)̐ΐАҐԐ "$8:<FHJL`bdnprt׺׳Ө׺׳ӝ׺׳Ӓ׺׳Ӈ׺׳|m|jh}OhCJUaJh}OhCJaJjzRhUjRhUjQhUjQhU hhjhTUmHnHujPhUhjhU haJjhUaJjOhThTUaJ)Ґ"Jr $$Ifa$gdw $$Ifa$gd) $$Ifa$gdđ5( $$Ifa$gd  $Ifgd=kdR$$IflֈjV^X %+ t0,44 layt)‘đƑ &(*468:NPR\^`bv|uj|u_|ujUhUjUUhU hhjhTUmHnHujThUhjhUjThThTUaJ haJjhUaJh}OhCJaJ"jhTCJUaJmHnHujh}OhCJUaJ#jSh}OhCJUaJ!8` $$Ifa$gdw $$Ifa$gd)vxzВҒԒ֒ "$&:׽ukeUkej\XhThTUaJ haJjhUaJ"jhTCJUaJmHnHu#jWh}OhCJUaJjh}OhCJUaJh5CJaJh}Oh5CJaJh}OhCJaJjVhUh hhjhTUmHnHujhUjAVhUԒ5,,, $Ifgd=kd-W$$IflֈjV^X %+ t0,44 layt)$LN“ $$Ifa$gdw $$Ifa$gd) $$Ifa$gd $Ifgd=:<>ʓŧړܓ<>@B^̸촩촞촓׈|s|djh}OhCJUaJh5CJaJh}Oh5CJaJh}OhCJaJj~ZhUjZhUjYhUh *hhhhhhmHnHujhhU hhjhTUmHnHujhUj(YhU&@df5,,, $Ifgd=kdZ$$Ifl0ֈjV^X %+ t0,44 layt)^`bhjʔ̔Δؔڔܔޔ(*,.Bóë|qfj_hUj_hUj^hU hhjhTUmHnHuj5^hUhjhUji]hThTUaJ haJjhUaJh}OhCJaJjh}OhCJUaJ#j[hThTCJUaJ&fhܔ,T $$Ifa$gdw $$Ifa$gd) $$Ifa$gd $Ifgd=BDFPRTVz~•ĕȕʕ̊xnhXnhTIjrbhUhjahThTUaJ haJjhUaJ"jhTCJUaJmHnHu#j0ah}OhCJUaJjh}OhCJUaJh^h6CJaJh5CJaJh}Oh5CJaJh}OhCJaJ hhjhTUmHnHujhUj`hUTVƕȕ5,,, $Ifgd=kdw`$$Ifl0ֈjV^X %+ t0,44 layt)ȕ<d $$Ifa$gdw $$Ifa$gd) $$Ifa$gd*,.8:<>RTV`bdfz|~̖ΖЖږܖuke haJjhUaJ"jhTCJUaJmHnHu#jmeh}OhCJUaJjh}OhCJUaJh}OhCJaJj>dhUjchUjRchUjhTUmHnHujbhUhjhU hh'ޖ5,, $Ifgd=kdd$$Ifl0ֈjV^X %+ t0,44 layt)(*,.BDFPRTVjlnxz|~ȗʗ̗ΗЗ׺׳Ө׺׳ӝ׺׳Ӓ׺׳Ӈ׺׳|m|jh}OhCJUaJh}OhCJaJjohhUjghUjghUjghU hhjhTUmHnHujfhUhjhU haJjhUaJjehThTUaJ),T|̗ $$Ifa$gdw $$Ifa$gd) $$Ifa$gd̗Η5,, $Ifgd=kdh$$IflֈjV^X %+ t0,44 layt)246@BDFZ\^hjln|uj|u_|ujkhUj>khU hhjhTUmHnHujjhUhjhUjjhThTUaJ haJjhUaJh}OhCJaJ"jhTCJUaJmHnHujh}OhCJUaJ#jih}OhCJUaJ!Dl $$Ifa$gdw $$Ifa$gd) $$Ifa$gdҘԘ֘ .0246JLNXZ\^r׽zjz_johUjEnhThTUaJ haJjhUaJ"jhTCJUaJmHnHu#jmh}OhCJUaJjh}OhCJUaJh}OhCJaJjlhUh hhjhTUmHnHujhUj*lhU"5,, $Ifgd=kdm$$IflֈjV^X %+ t0,44 layt)4\ԙ $$Ifa$gdw $$Ifa$gd) $$Ifa$gdrtv™ęƙЙҙԙ֙ "bdӽӲקk&j rhThT5CJUaJh*#h*#5CJaJ jh*#h*#5CJUaJ *h*#5CJaJh}OhCJaJjphUjgphUjohUh hhjhTUmHnHujhUj{ohU#5--(gd+$a$gd*#kdSq$$IflֈjV^X %+ t0,44 layt)ޚ(*FHJLļyg_TEjh/Uh`CJUaJh#h`CJaJh`CJaJ#jnsh/Uh+CJUaJ#jrh/Uh+CJUaJh/Uh+CJaJjh/Uh+CJUaJh/Uh+CJaJh/Uh+5CJaJh+CJaJh#h CJaJh*#h*#5CJaJ jh*#h*#5CJUaJ&jrhThT5CJUaJwwc$$If]^a$gd/U $Ifgd`gd+pkds$$Ifl+(, t0644 lap yt/U $Ifgd+ ƝȝPR\^`ʞ̞֞؞ܞޞ$&(RTVԿzvzrkdzvzrkd hzjh:q hzjhzjhh)hhaJmHnHuh/ +jh/ +Uh:q h:q CJaJhph:q 5CJaJhph:q 5CJaJh#hCJaJ(jh/Uh`CJUaJmHnHujh/Uh`CJUaJ#jpth/Uh`CJUaJh/Uh`CJaJ'xsjaa $Ifgd $Ifgdpgd kd2u$$Ifl{0Hv t044 lapyt/Uĝ $Ifgd $Ifgdpfkdu$$IflF>+*r t6    44 laĝƝ`(T}} $Ifgd $Ifgd:q $Ifgdpfkd*v$$IflF>+*r t6    44 laTVXZ\^` $Ifgd $Ifgdpfkdv$$IflF>+*r t6    44 laV`bz|h#h 5h#h CJaJhzj hzjhzjh:q h:q CJaJ hzjh:q `b $Ifgd $Ifgdpfkdw$$IflF>+*r t6    44 lagd fkdw$$IflF>+*r t6    44 la50P/ =!@"@#@$h% DptD@Text1$$If!vh#v#vN #v:V l40++,55N 5/ 4ytAD Dropdown1 Atlantic City BridgetonCamden ElizabethFreehold Hackensack Jersey CityLebanon Mt. Arlington Mt. HollyNewark New BrunswickPaterson Toms RiverTrenton$$If!vh#v#vN #v:V l40++,55N 5/ 4ytAtDText6tDeCheck1tDeCheck2tDCheck3xD@Text101$$If!vh#vz#vV#v#vr:V l4^)v)v++,,5z5V55r/ / / / / 4f4ytujD<vD@<Text16$$If!vh#vz#vV#v#vr:V l4++,,5z5V55r/ / / / / 4f4ytutDText8hDehDevDText17$$If!vh#vz#v #v#vr:V l4+++,,5z5 55r/ / /  / / 4f4ytuvDText77$$If!vh#vz#vV#v#vr:V l4++++,,5z5V55r/  / /  / 4f4yt`vD<Text18$$If!vh#vz#vV#v#vr:V l4+++,,5z5V55r/ / / 4f4ytuvD@<Text19$$If!vh#vz#vV#v#vr:V l4)v++,5z5V55r/ / / / / / 4f4ytuvD<Text10$$If!vh#vz#vV#v#vr:V l4++,,5z5V55r/ / / / 4f4ytuvDText11tDeCheck4tDeCheck5vD<Text20$$If!vh#vz#vV#v#vr:V l4P)v)v+++,,5z5V55r/ / / / / / / 4f4ytuvD(Text21$$If!vh#vz#vV#v#vr:V l4)v)v+++,,5z5V55r/ / / / / /  / / 4f4ytuvD@<Text12vDText22$$If!vh#vz#vV#v#vr:V l4)v)v++,,5z5V55r/ / / / / / / 4f4ytuvDText13vDText23$$If!vh#vz#vV#v#vr:V l4)v)v+++,,5z5V55r/ / / /  / / / 4f4ytuvDText14$$If!vh#vz#vV#v#vr:V l4m)v)v+++,,5z5V55r/ / /  4f4ytuvD@(Text15$$If!vh#vz#vV#v#vr:V l4j)v)v++,,5z5V55r/ / / / / 4f4ytuxDText103xDText104xDText105$$If!vh#v$#v:V l{ t06,5$5pyt/UvDText24vDText25vDText26vDText262D JanuaryFebruaryMarchAprilMayJuneJulyAugust SeptemberOctoberNovemberDecemberD 2013201420152016Q$$If!vh#v(,:V l t65(,p yt/UtDeCheck6M$$If!vh#v#v"):V l t655")tDeCheck7M$$If!vh#v#v"):V l t655")xDText106$$If!vh#v(,:V s t0(,5(,4 sp yt/U$$If!vh#v#vj#v:V l40++,55j5/ 4ytA$$If!vh#v#vj#v:V l40++,55j5/ 4ytAvDText29vDText30vDText31vDText32vDText33$$If!v h#v#v#vW#v#vD#v#v#v#v #v :V H t0, 555W55D5555 5 / / / / / 4 Hpdyt/Ukd'$$IfH $ { ^B$i+WD t0((((44 Hapdyt/U$$If!v h#v#v#vW#v#vD#v#v#v#v #v :V H t0, 555W55D5555 5 / / / / / / / / / / 4 Hpdyt/Ukd+$$IfH $ { ^B$i+WD t0((((44 Hapdyt/UjDjDjDjDjD:$$If!v h#v#v#vW#v#vD#v#v#v#v #v :V H t0, 555W55D5555 5 / / / / / / / / / / / / /  / / 4 Hpdyt/Ukdd2$$IfH $ { ^B$i+WD t0((((44 Hapdyt/UvDeCheck26vDeCheck27$$If!vh#v#v#vW#v#vD#v#v#v:V H t0,555W55D555/ / / / / / / / / / 4 HpPyt/U+kd8$$IfHִ$ { ^Bi+WD t0    44 HapPyt/UjD$$If!vh#v(,:V s( t0(,5(,/ p yt/UtDeCheck8tDeCheck9vDeCheck10vDeCheck11vDText40vDText41vDText42Q$$If!vh#v(,:V lM t65(,p yt/U$$If!vh#v#vj#v:V l40++,55j5/ 4yt/ +$$If!vh#v#vj#v:V l40++,55j5/ 4yt/ +$$If!vh#v#v#v#v#v:V l t0,55555ytvDText43Df Petitioner Pet. Attny. Resp. Attny.jDvDText44vDText45vDText46vDText47$$If!vh#v#v#v#v#v:V l0 t0,,55555yt)vDText48Df Petitioner Pet. Attny. Resp. Attny.jDvDText44vDText45vDText46vDText47$$If!vh#v#v#v#v#v:V l t0,,55555yt)vDText53Df Petitioner Pet. Attny. Resp. Attny.jDvDText44vDText45vDText46vDText47$$If!vh#v#v#v#v#v:V l t0,,55555yt)vDText73Df Petitioner Pet. Attny. Resp. Attny.jDvDText44vDText45vDText46vDText47$$If!vh#v#v#v#v#v:V l t0,,55555yt)vDText57Df Petitioner Pet. Attny. Resp. Attny.jDvDText44vDText45vDText46vDText47$$If!vh#v#v#v#v#v:V l t0,,55555yt)vDText61Df Petitioner Pet. Attny. Resp. Attny.jDvDText62vDText63vDText64$$If!vh#v#v#v#v#v:V l0 t0,,55555yt)DfSelect Stenographic Svc. Global Court Reporting ServicesJersey Shore Reporting, LLCJohn F. Trainor, Inc.William C. O'Brien Assoc., Inc.Df Petitioner Pet. Attny. Resp. Attny.jDvDText44vDText45vDText46vDText47$$If!vh#v#v#v#v#v:V l0 t0,,55555yt)vDText69Df Petitioner Pet. Attny. Resp. Attny.jDvDText44vDText45vDText46vDText47$$If!vh#v#v#v#v#v:V l0 t0,,55555yt)vDText73Df Petitioner Pet. Attny. Resp. Attny.jDvDText44jDvDText46vDText47$$If!vh#v#v#v#v#v:V l t0,,55555yt)jDDf Petitioner Pet. Attny. Resp. Attny.jDvDText44vDText45vDText46vDText47$$If!vh#v#v#v#v#v:V l t0,,55555yt)vDText73Df Petitioner Pet. Attny. Resp. Attny.jDvDText44vDText45vDText46vDText47$$If!vh#v#v#v#v#v:V l t0,,55555yt)vDeCheck24vDeCheck25vDeCheck24vDeCheck24$$If!vh#v(,:V l t06,5(,p yt/UD(Text107 UPPERCASE Judge NameEnter Judge's Name$$If!vh#v#vv:V l{ t055vpyt/U[$$If!vh#v*#v#vr:V l t65*55rw$$If!vh#v*#v#vr:V l t65*55r/ / w$$If!vh#v*#v#vr:V l t65*55r/ / i$$If!vh#v*#v#vr:V l t65*55r/ i$$If!vh#v*#v#vr:V l t65*55r/ ^ 2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH 8`8 zjNormal_HmH sH tH H@H @~ Heading 1$@&5OJQJ^JaJDA D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List @O@ H2$dd@&5CJ$htH uDCD Body Text Indent `B'`B `BComment ReferenceCJaJH@"H  Balloon TextCJOJQJ^JaJ4@24 `B Comment Text@j@12@ `BComment Subject5\jSj n Table Grid7:V0PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3N)cbJ uV4(Tn 7_?m-ٛ{UBwznʜ"Z xJZp; {/<P;,)''KQk5qpN8KGbe Sd̛\17 pa>SR! 3K4'+rzQ TTIIvt]Kc⫲K#v5+|D~O@%\w_nN[L9KqgVhn R!y+Un;*&/HrT >>\ t=.Tġ S; Z~!P9giCڧ!# B,;X=ۻ,I2UWV9$lk=Aj;{AP79|s*Y;̠[MCۿhf]o{oY=1kyVV5E8Vk+֜\80X4D)!!?*|fv u"xA@T_q64)kڬuV7 t '%;i9s9x,ڎ-45xd8?ǘd/Y|t &LILJ`& -Gt/PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!0C)theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK]   R @LhNT %bd,̐v:^BrV #'(+.02479;>?ACPSVY[^`cehjloqtvy{} l   RT6RP`w zDx# Ќ`LzffTȕ̗ĝT`!"$%&)*,-/13568:<=@BQRTUWXZ\]_abdfgikmnprsuwxz|~ 6FUe!6FUeu!'1=Ceqw'7Scu!'4@F]io (.lx~ 2BHXcsx g s y     ) / G S Y s    6 F ; K Y i y eu ,8>couP\bfvx%+-9?AMSUagjv|  +13?EGSY[gmo{  ,26FHTZ]{"$068DJLX^#&68DJLX^`lrt  &)5;>NP\bdpvx1AJZ!$BHFS FG$G$G$FFFFG$G$FFFFFFG$G$FFFFFFFFFFFFFFFS$S G$G$FFFFFFFFFFFG$G$FG$G$G$G$FFFFS$FFFFFFS$FFFFFFS$FFFFFFS$FFFFFFS$FFFFFFS$FFFFS$S$FFFFFFS$FFFFFFS$FFFFFFS$FFFFFFS$FFFFFG$G$G$G$F8@0(  B S  ?2Text1 Dropdown1Text101Text16Text8Text19Text12Text15Text103Text104Text105Text24Text25Text26 Dropdown2 Dropdown3Check6Check7Text106Text29Text30Text31Text32Text33Check26Check27Check8Check9Check10Check11Text40Text41Text42Text43Text44Text45Text46Text47Text48Text53Text57Text61Text62Text63Text64Text69Text73Check24Check25Text107l (Fdy   G  7 < Z z f ,Qk!*  !"#$%&'()*+,-./01"(/CHt  0 Z  G L j v?c}3<I>I>I>I>I>I>  9*urn:schemas-microsoft-com:office:smarttagsplace9*urn:schemas-microsoft-com:office:smarttagsState 8:M O 33"'/lABHY g z    0 G Z s   ,?cvPcx,-@ATUhj} 23FGZ[no  3H[]#$78KL_$8KL_`st')<Pcdwx"$I"'/lABHY g z    0 G Z s   ,?cvPcx,-@ATUhj} 23FGZ[no  3H[]#$78KL_$8KL_`st')<Pcdwx"$I'_YhJ*^`.^`.p^p`.@ ^@ `.^`.^`.^`.^`.^`.^`.p^p`.@ ^@ `.^`.^`.^`.^`.hh^h`o(.'_Yh3 @h ^`OJQJo(B Wp:q  NG O 5n  e&D+2S9 &A^#L:HON _"*#;l%i<(_M*+/ +h,y--w.12I3&5?5ix5L7I868d:|:t;/.=?n{?P(@`RA`B"NCHEYJ[8KtGLTGSeT/UjUXXY=YI\)G]_v!_^Vabacacca6cVdce%|gi 8iXi{kl'mmYo-qo5tuc|wkIx1{w{=~ J 8q| @X+,^) n)-C9NXIJ +)u:CDNzjSpMPrp3ui_ #  s*&g0$LAfq@~)8)T`| 9}OMWhnrc_l8fm.$[`XgNO(*le)ai!u=[tF|[p0fr9Ow@ HYHH+  0@@@$&UnknownG*Ax Times New Roman5Symbol3. *Cx Arial5. .[`)TahomaA$BCambria Math"hGgJ 77˕$24||3QHX? *!xx State of New Jerseylawkosn Windows User    Oh+'0  4 @ L Xdlt|ӣƵlawkosn Normal.dotmWindows User4Microsoft Office Word@d@D |]L@p$@A՜.+,0 hp  ӣƵ Dept. of Labor7| ӣƵ Title  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~Root Entry FYAData w1TableAWordDocument 7 SummaryInformation(DocumentSummaryInformation8MsoDataStoretHAVAYCZXEZQAWKN5A==2tHAVAItem  PropertiesUCompObj r   F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q