A lawsuit has been filed against you regarding workers' compensation claims.

STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS WORKERS' COMPENSATION APPEALS BOARD SPECIAL NOTICE OF LAWSUIT (Pursuant to Labor Code 3716 and Code of Civil Procedure Sections 412.20 and 412.30) WCAB NO.: 15406483 To: DEFENDANT, ILLEGALLY UNINSURED EMPLOYER: AVISO: Usted esta siendo demandado. La corte puede expedir una decisiOn en contra suya sin darle la o ortunidad de defenderse a menos que usted actue pronto. Lea la siguiente informaci¢n. ______________________________________________________ Rudy Pineda Hernandez | Jose Ozuna aka Jose Osuna | | | | Applicant | Defendant(s). _______________________________________________________ NOTICES 1) A lawsuit, the Application for Adjudication of Claim, has been filed with the Workers' Compensation Appeals Board against you as the named defendant by the above-named applicant(s). You may seek the advice of an attorney in any matter connected with this lawsuit and such attorney should be consulted promptly so that your response may be filed and entered in a timely fashion. If you do not know an attorney, you may call an attorney reference service or a legal aid office. You may also request assistance / information from an Information and Assistance Officer of the Division of Workers' Compensation. (See telephone directory.) 2) An Answer to the Application must be filed and served within six days of the service of the Application pursuant to Appeals Board rules; therefore, your written response must be filed with the Appeals Board promptly; a letter or phone call will not protect your interests. 3) You will be served with a Notice(s) of Hearing and must appear at all hearings or conferences. After such hearing, even absent your appearance, a decision may be made and an award of compensation benefits may issue against you. The award could result in the garnishment of your wages, taking of your money or property, or other relief. If the Appeals Board makes an award against you, your house or other dwelling or other property may be taken to satisfy that award in a non judicial sale, with no exemptions from execution. A lien may also be imposed upon your property without further hearing and before the issuance of an award. 4) You must notify the Appeals Board of the proper address for the service of official notices and papers and notify the Appeals Board of any changes in that address. TAKE ACTION NOW TO PROTECT YOUR INTERESTS! Issued by: WORKERS' COMPENSATION APPEALS BOARD _______________________________________________________ Name and Address of Appeals Board: WORKERS' COMPENSATION APPEALS BOARD Name and Address of Applicant's Attorney: Juan C. Flores 515 Folsom Street, Third Floor San Francisco, California 94105 FORM COMPLETED BY: Juan C. Flores Telephone No.: (415) 495-7800 _______________________________________________________ WCT 6945951 Feb. 2, 9, 16, 23, 2026