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The document is a motion filed in the Justice Court of a township in Nevada, requesting to place a small claims case on the calendar for a hearing. It includes sections for both the plaintiff and defendant to make requests, as well as details for notification and scheduling of the hearing.

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How do I get a CMS 1500 form?

In order to purchase claim forms, you should contact the U.S. Government Printing Office at 1-866-512-1800, local printing companies in your area, and/or office supply stores. Each of the vendors above sells the CMS-1500 claim form in its various configurations (single part, multi-part, continuous feed, laser, etc).

Can I print a CMS 1500 form PDF?

Printing your CMS 1500 form After saving your claim form, you can submit it electronically through SimplePractice, or download it to print. Important: If you are downloading a secondary claim form, you will notice that the downloaded PDF does not match that of the claim form you see in SimplePractice.

What is a C3 form in Nevada?

C3 Employers Report of Industrial Injury or Occupational Disease: The employer must provide this completed, signed and dated form to the insurance carrier within 6 working days of receipt of the C-4 form (Employees Claim for Compensation/Report of Initial Treatment) per Nevada Revised Statute NRS 616C.

What is a D6 form in Nevada?

INJURED EMPLOYEES REQUEST FOR COMPENSATION.

How do I print a 1500 claim form?

Printing your CMS 1500 form Open the claim. Click the download icon. Select Download complete form if you want to generate the full, red CMS 1500 form as a PDF. Select Download field entries only if you want to only generate the data fields so you can print it onto a blank CMS 1500 form.