LEGAL NOTICE
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.: ADJ19063092
To: DEFENDANT, ILLEGALLY UNINSURED EMPLOYER:
AVISO: Usted esta siendo demandado. La corte puede expedir una decision en contra suya sin darle la oportunidad de defenderse a menos que usted actue pronto. Lea la siiruiente informaci6n.
Faustina Imperial
Applicant.
Tacos El Tony; and Bartolome Antonio Hernandez, individually, and as beneficial interest holder of Tacos El Tony
Defendant(s).
NOTICES
Defendant(s).
I) 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/ infonnation from an Infonnation 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 abseut 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 ofyour 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
WORKERS' COMPENSATION APPEALS BOARD
Name and Address of Appeals Board:
WORKERS' COMPENSATION APPEALS BOARD
Name and Address of Applicant's Attorney:
Markus Urstoeger 1600 G street Suite 203 Modesto CA 95354
FORM COMPLETED BY:
Telephone No.: (209) 521-2552
NOTICE TO THE PERSON SERVED: You are served:
I. XX as an individual defendant
2. XX as the person sued under the fictitious name of{specify): Tacos El Tony
IPL0333512
Apr 24,May 1,8,15 2026